Antidepressants are effective, study shows

Adjust Comment Print

"We don't have any very precise treatments for depression at this point in time", said Geddes.

'Medication should always be cnsidered alongside other options, such as psychological therapies, where these are available'.

But several experts also said its results gave a clear message.

Depression affects around 300 million people across the world, according to the World Health Organisation. Most drugs are barely effective if at all, which is something authors of this study admit.

Researchers carried out a systematic review and network meta-analysis of data from placebo-controlled and head-to-head trials of 21 antidepressants used for the acute treatment of adults with major depressive disorder.

The new study from the University of Oxford collected data from 522 trials encompassing a total of over 116,000 participants. In general, newer antidepressants tended to be better tolerated due to fewer side effects, while the most effective drug in terms of reducing depressive symptoms was amitriptyline - a drug first discovered in the 1950s.

"This analysis of a huge number of studies of antidepressants confirms that they are much more effective than placebo - itself a powerful treatment in depression".

Barclays profits damaged by charges including £127m Carillion hit
He added: "We have already started to see some of the benefits of our work in 2017". But with one-off charges stripped out, underlying profits were £3.5bn, up 10%.

Researchers also examined tolerability with the best agomelatine, citalopram, escitalopram, fluoxetine, sertraline and vortioxetine. Amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone and venlafaxine were the least tolerated and had the highest dropout rates.

Overall, the analysis found that 21 common antidepressants were at least somewhat effective.

Although important, these results do not answer the question about the long-term effects of antidepressants, and a network meta-analysis approach can not be used on the individual patient level, Sagar V Parikh, MD, department of psychiatry, University of MI, and Sidney H Kennedy, MD, department of psychiatry, University of Toronto, wrote in an accompanying comment. There are still significant voids in our understanding of depression, but this should ease the mind of both doctors administering and patients taking the antidepressants. The first three "might be considered first choice" by doctors, they write, although the two most effective drugs - amitriptyline and venlafaxine - might still be first choice for severe depression. Through the Freedom of Information Act, the FDA demands pharmaceutical companies provide data on all the clinical trials they sponsor - including unpublished trials.

Prof Helen Stokes-Lampard, chair of the Royal College of Global Positioning System, said taking antidepressants was frequently portrayed as a negative thing "but this in itself can add to the unfortunate stigma that sometimes exists around people with mental health conditions". "It should never be swept under the carpet or ignored".

She said: "Also, this paper does not help us understand how best to help patients who have treatment-resistant depression and can not improve on any of the 21 antidepressants tested here".

James Warner, a psychiatrist at Imperial College London, added: "Depression causes misery to countless thousands every year and this study adds to the existing evidence that effective treatments are available".

Comments