Anti-depressants 'of Little Use'

[howtoescape]

New generation anti-depressants have little clinical benefit for most patients, research suggests.

The University of Hull team reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.

They found the drugs helped only a small group of the most severely depressed, and in most cases had no more effect than taking a dummy pill.

The Royal College of Psychiatrists said the findings were "very important".

In total, the Hull team, who published their findings in the journal PLoS Medicine, reviewed data on 47 clinical trials.

They focused on drugs in the class known as Selective Serotonin Reuptake Inhibitors (SSRIs), which work by increasing levels of the mood controlling chemical serotonin in the brain.

These included fluoxetine (Prozac), venlafaxine (Efexor) and paroxetine (Seroxat) - all commonly prescribed in the UK.

There seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients

Professor Irving Kirsch

University of Hull

The number of prescriptions for anti-depressants hit a record high in England in 2006 - even though official guidance stresses they should not be a first line treatment for mild depression.

The researchers found that even the positive effects seen on severely depressed patients were relatively small, and open to interpretation.

The seemingly good result came from the fact that these patients' response to the placebo decreased, rather than any notable increase in their response to anti-depressants.

Lead researcher Professor Irving Kirsch said: "The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.

"This means that depressed people can improve without chemical treatments.

"Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit."

'Small subset'

Professor Kirsch said the findings called into question the current system of reporting drug trials.

Dr Tim Kendall, deputy director of the Royal College of Psychiatrists Research Unit, has published research concluding that drug companies tend only to publish research which shows their products in a good light.

He said the Hull findings undermined confidence in the ability to draw meaningful conclusions about the merit of drugs based on published data alone.

He called for drug companies to be forced to publish all their data.

The National Institute for Health and Clinical Excellence (NICE) is currently reviewing its guidance on the use of antidepressants.

A spokesman for GlaxoSmithKline, which makes Seroxat, said the study only looked at a "small subset of the total data available".

And Eli Lilly, which makes Prozac, said that "extensive scientific and medical experience has demonstrated it is an effective anti-depressant".

http://news.bbc.co.uk/1/hi/health/7263494.stm

Exercise, Is better then any drug when feeling down or depressed IMO.

[mrtoad]

I think the title is a little misleading.

The main problem with anti-depressants is that they are all to frequently prescribed inappropriatley by overworked or lazy G.P'S. The amount of patients who are now on Anti depressants in the UK and US is truly quite shocking, when you consider that the majority of them are not suffering from Severe Mental Illness. In the end, a combination of therapy and lifestyle changes would benefit a lot of people who put all of their hopes on the pill to cure there social and psychological ills. Lazy prescribing is realy the root of the problem, along with lazy people who do not want to take responsibility for their own life.

As the report says, there are clear benefits to those suffering from severe depression, and I would take this phrase to mean those with a Clinical depression under the DSM guidelines, i.e. those with properly diagnosed depression, which is a terrible illness and requires significant treatment, therapy and support. From my own personal experience of working in the NHS, Anti-depressants do have a theraptic value for many, many people and have helped a great deal of people effectively, but never when used just alone. As with a lot of research, if you set up the conditions in a certain way then you will get the results. I'd be intersested to know a little bit more about the research methodolgy of this particular study along with the clinical trials before I jump to any further conclusions. I thin it is also important to realise that Psychaitry results are a lot more difficult to measure than standard general medical clinical trials.

[CymruAmByth]

I got so depressed when I read this in the paper this morning.

[gunnyd]

Let's not forget about Tom Cruise and the Church of Scientology. All psychological problems stem from bad thoughts and you have to get rid of all of those bad things through auditing, and spending a load of cash so that you can be "Clear"

I'd be interested in the scope and length of this study. Before the innovations of psychotropic medication. Many people ended up in insane asylums, and sanatoriums. Are anti-depressants over prescribed? Absolutely. But you cant throw out a whole class of modern drugs for that reason only. There are people that genuinely need them. And you can't just hand out the pills and send the patient on their way. You must include psychotherapy "Talk Therapy" as an integral part of treatment.

The mentally disturbed, GunnyD.