For years, there has been a debate over the effectiveness of antidepressants. Do they really work, or can the benefits be put down to a placebo effect? Both doctors and patients have been questioning the results of them for some time. But with depression affecting an estimated 350 million worldwide, and costing around $210 billion per year in the US alone, medical professionals agree that the quality and availability of treatment desperately needs to be improved.

Just one in six individuals suffering from depression receive adequate treatment in developed countries. In developing countries, the figure is far lower –  just one in 27. But are prescribing more antidepressants the way forward? Many are suspicious of drug companies, claiming that they are exaggerating the results in trials. There are also some individuals who argue that they don’t want to take pills for a mental health issue and therapy would be more suitable.

A new study, which was published in the Lancet, has shown that despite the concerns, antidepressants do work in reducing the symptoms of depression. It has also shown that there’s a varying level of effectiveness between different types of pills. For example, fluoxetine, which is very commonly used, is one of the least effective but was one of the best tolerated by patients. The drug amitriptyline was shown to be the most effective out of all the drugs tested.

As a result of this study, doctors have agreed that millions of people should be offered antidepressants in combination with therapy to treat moderate to severe depression. “Antidepressants are an effective tool for depression. Untreated depression is a huge problem because of the burden to society,” said Andrea Cipriani of the NIHR Oxford Health Biomedical Research Centre, who led the study.

John Geddes, professor of epidemiological psychiatry at Oxford University also noted: “Depression is the single largest contributor to global disability that we have – a massive challenge for humankind. “ He added that, in the UK “it is likely that at least one million more people per year should have access to effective treatment for depression, either drugs or psychotherapy. The choice will need to be made by doctor and patient.”

Studies have shown that antidepressants and therapies like CBT have similar success rates when it comes to treating depression. Around 60% of people have a positive response within two months, resulting in an improvement in their mood, sleep, appetite and other symptoms. However, most stop taking them before the two months due to the side effects.

The researchers pointed out that the development of new treatments is crucial in reducing the symptoms of depressions. The majority of drugs on the market currently SSRIs, however Geddes noted that:  “We don’t have any very precise treatments for depression at this point in time. It is a massive problem that the industry has pulled out because they found this area very challenging to work in.”

Professor Carmine Pariante, spokesperson for the Royal College of Psychiatrists, said that the new study “finally puts to bed the controversy on antidepressants, clearly showing that these drugs do work in lifting mood and helping most people with depression.” She added: Importantly, the paper analyses unpublished data held by pharmaceutical companies, and shows that the funding of studies by these companies does not influence the result, thus confirming that the clinical usefulness of these drugs is not affected by pharma-sponsored spin.”

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