News

Research questions if antidepressants any better than a placebo

16 May 2016

Q&A

Should I stop taking my anti-depressant medication?

No. People should continue to take their medication and discuss any concerns with their doctor. Stopping medication suddenly can have serious side effects. If you and your doctor or treatment team decide to stop medication it is better to come off them gradually, and for people around you to know that is what you are doing. It is important to get regular follow up care from your GP during this period, in case your symptoms return and are not manageable.

Are antidepressants effective?

Studies show that antidepressants can help many people with depression to get better more quickly in particular people with more moderate-severe depression. Everyone is different and some people may find one type of antidepressant works better for them than another.

Does everyone with depression need to be on antidepressants?

Not everyone with depression needs antidepressant medication to get better. In most cases, people with mild-moderate depression may find that some lifestyle changes such as regular physical activity, enough sleep, and a healthy diet coupled with psychological therapy, such as cognitive behaviour therapy, will help them to overcome their depression. People with more moderate-severe depression may need a combination of lifestyle changes, psychological therapy and antidepressant medication. It is important to talk to your GP or a mental health professional to find out what the best treatment options are for your particular condition and situation.

What if I am not getting better?

While the majority of people will get better with psychological treatments plus or minus antidepressant medications, some people find they may still have some ongoing difficulties. A number of more specialised forms of treatment are available for people who are not recovering with these usual treatments, and it is best to consult a psychiatrist who can guide you through other treatment options.

What kind of questions should I ask my GP?

Beyond Blue’s Have The Conversation resource has some useful tips for having a conversation with your GP. More information is available here.

 

Research questions if antidepressants any better than a placebo?

An article published on May 16 in the Medical Journal of Australia claimed the effectiveness of antidepressants is lower than previously thought.

Dr Christopher Davey and Professor Andrew Chanen from Orygen, the National Centre of Excellence in Youth Mental Health and The University of Melbourne noted that, as more trials were conducted and the results of negative trials were included, the difference between antidepressants and placebos was not as great as in early studies.

Professor Brett McDermott, consultant child and adolescent psychiatrist and Beyond Blue Board Director, said it was not uncommon in clinical trials on any type of medication to find that the results of early studies show stronger benefits than later trials. In part this is because early trials often include people with more ‘textbook’ diagnoses and no other factors likely to complicate their recovery, whereas later, more real world trials often include people with more complex conditions. Experts are also getting better at considering trials that might not have been widely published so they can base their recommendations on a comprehensive review of all the research evidence.

Georgie Harman, Beyond Blue CEO agreed that while the results of more recent studies of antidepressant medication and psychotherapy were not as positive as early studies, it did not mean that antidepressants or psychotherapy were not effective. “Most people with depression will find that current treatments will assist with their recovery,” she said.

“While antidepressants and psychosocial therapies such as counselling have their limitations, it does not mean they are not useful if used in the right way.

“Beyond Blue's position for many years, which is in line with current clinical guidelines and the recommendations of the authors of the Orygen study, it that is best to start with lifestyle changes and psychological therapies for mild-moderate depression and only add antidepressants if a person is not improving and to use a combination approach of lifestyle, psychological therapy and medication for more severe depression. If a person is still not well they should consider seeing a psychiatrist to obtain more specialised treatment.

“Ultimately we need to help people access the treatments that are right for them while continuing to support research into new and better treatments. The importance of other forms of emotional and practical support – from friends and family, staying connected socially, paid or voluntary work, eating well, exercise and adequate sleep – also cannot be underestimated.”

Ms Harman concluded by saying that it was important for people to remember that help is available and that anyone experiencing depression should talk to their GP or mental health professional about treatment options and what would be best for them and not be afraid to ask questions.

“No-one should stop taking their medication suddenly without consulting their doctor.”

Mental health professionals are available at the Beyond Blue Support Service via phone 24/7 on 1300 22 4636 or via www.beyondblue.org.au/get-support for online chat (3PM-12AM AEST) or email responses (within 24 hours).

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