27 February 2007
Are antidepressants effective?
Statement from Assoc. Professor Michael Baigent, Clinical Adviser to beyondblue: the national depression initiative
Recent research into SSRI antidepressants published in the US journal Public Library of Science Medicine claims that only people with severe forms of depression show any benefit from the antidepressants studied. It also claimed, in people with milder depression, the response to the antidepressants was no better than a placebo (i.e. a dummy pill).
The study, entitled Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data submitted to the Food and Drug Administration, analysed data from clinical trials which had been lodged with the US Food and Drug Administration, but also included data from trials of these medications which had not been previously published.
Clinical Adviser to beyondblue: the national depression initiative Assoc. Prof Michael Baigent welcomed the report: "This is important research because it includes the results of trials that previously haven't been published. It overcomes any preference that exists to publish studies just with good outcomes. It shows that some of the newer antidepressants that we prescribe in Australia are not as effective for mild to moderately depressed people as they are for people with more severe depression."
"We know there has been a bias to publish results that only show a positive outcome and as clinicians, we have known for a long time that not everyone responds in the same way to antidepressants. It's important to get the full picture. Not everyone with depression needs antidepressant medication to recover, but many people do," he said.
Assoc. Professor Baigent said that there are years of clinical experience and good evidence to show that antidepressants can be effective - and that psychological therapies are also effective in treating depression.
"If you are taking any of the antidepressants mentioned in the study, don't be alarmed. If the medication is helping you, don't worry because the research is not saying there is a problem with these antidepressants....so don't stop taking them abruptly. If however, you are not responding to the treatment in the way you'd hoped, go back and talk it over with your doctor. People don't always respond to the first antidepressant prescribed - so you need to continue the treatment until you're well," he said.
"As clinicians, we know because everyone is different, it's important to tailor the treatment to the individual person. It can take months for people to recover from depression and often people recover with psychosocial treatments (talking therapies), lifestyle changes and if indicated, medication."
While Assoc. Professor Baigent doesn't believe the research findings are flawed, he said: "In the real world, treatment for people with depression would also involve psychological treatments alongside medication. People vary enormously as to the type and their severity of depression."
"One of the good things about this research is that it reinforces the importance of psychological treatments as well as medication, in treating the complexities of depression. One size doesn't fit all - but if you do get the right treatment, most people recover from depression."
To read the report Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data submitted to the Food and Drug Administration, go to www.plosmedicine.org
To find out more about antidepressants click on the links below to read beyondblue fact sheets:
