Antidepressants more efficient than placebo

| Positive effects of antidepressants.

by Anna Westerberg

The stigma surrounding antidepressants could be lifted by a new study that has found that antidepressants work.

Researchers from six countries, including the UK, Switzerland, Japan, France, Germany and USA, have studied 116,477 people through 522 trials. The study looked at 21 antidepressant drugs for adults with major depressive disorder.

Dr Andrea Cipriani at the Department of Psychiatry at Oxford University said this research is the largest meta-analysis ever carried out in psychiatry. Half of the data included in the analysis come from unpublished sources, “and this is an important thing because we know that published studies tend to overestimate the efficacy of antidepressants”, said Dr Cipriani.

The results are based on adults having their first or second experience of depression, as these are the most typical patients seen in a GPs office.

The drugs compared in the study were the most commonly prescribed antidepressants. Since many of the drugs in the research are included in the WHO list of essential medicines, the results are not Western-focused, but are based on drugs used worldwide.

According to Dr Henricus Ruhe from Department of Psychiatry at Radboud University, Netherlands, this study, once and for all, shows that placebo are not comparable to the effect of antidepressants. “Those claims are stigmatizing the people who are taking antidepressants. As if they were fools that are taking ineffective drugs,” said Dr Ruhe. "I’ve never heard those doubts in case of rheumatoid arthritis or diabetes.”

The research focuses on adults in need of acute treatment, and what effect antidepressants have for short term treatments. However, Dr Cipriani said the researchers are currently involved in a parallel project, looking at the long term effect of antidepressants.

Dr Cipriani also stressed the importance of looking for alternative treatment besides antidepressants, as drugs should not necessarily “always be the first line of treatment”, according to Dr Cipriani. Another option, which may work well together with antidepressants and should always be offered alongside drugs, could be psychological therapy. Dr Cipriani feels strongly about informing the patients about their options, including the benefits from antidepressants.

When it comes to burying the hatchet between supporters of antidepressants and those who believe they don’t work, Dr Cipriani said, “Unfortunately, we know that about one third of patients with depression will not respond [to antidepressants]”. He believes, although the study shows antidepressants are effective, “there is still a need to improve treatments further”.

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