Popular antidepressants are a waste of time for most depressed people, research suggests.
A review of clinical trials for antidepressant drugs regularly prescribed in Australia found they worked no better than a placebo for mildly depressed patients and most people suffering severe depression. The study, which used research on drugs, including Prozac, Efexor and Aropax, that drug firms had not previously released, has been applauded by experts for its scope and integrity
Researchers, led by Professor Irving Kirsch from the University of Hull in Britain, analysed 47 clinical trials using data released under freedom of information rules by the US Food and Drug Administration. Their research was published in Public Library of Science (Medicine). It showed the efficacy of antidepressants on some severely depressed people was only demonstrated by their decreased response to a placebo, rather than increased responsiveness to the drug.
The researchers concluded there was "little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective".
President of the Australian Psychological Society, Amanda Gordon, and Michael Baigent, a clinical adviser to BeyondBlue, lauded the research for "ferreting out" unpublished trial results.
Dr Baigent said doctors had long known that only some people responded to antidepressants. "We're a long way from being able to pinpoint which groups respond best to antidepressants."
Dr Gordon urged more independent research into the efficacy of antidepressants. "There's been this whole medicalisation of unhappiness that has taken place over the last 20 years," she said.
Professor Gordon Parker, executive director of the Black Dog Institute, said the research was flawed because trial participants were different to patients seen by doctors in the real world.
He said participants were not allowed to have been using drugs, alcohol or to have had suicidal thoughts.
"Psychiatrists don't see people like that. It would be like testing asthma drugs on someone who is simply out of breath because they've just run into the surgery," he said.
Dr Baigent urged people who had benefited from antidepressants to keep taking them. "The study does not say there's no benefit from them," he said.
Australian doctors wrote more than 12 million prescriptions for antidepressants in 2005-06.
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