Anti depressant efficacy is overrated

Is anti depressant efficacy overrated and are anti depressants right for you?

This is a question many people suffering from symptoms of depression are concerned with – is treatment with anti depressants suitable for them or not? While this is a question for you and your doctor to decide, it may be worthwhile considering the wider options too.

Anti depressants are not that effective. And people may be better to look at psychotherapy to combat mild depression - that is what a meta analysis of the research done into the effectiveness of antidepressant medication claims. The report published in the Journal of the American Medical Association involved nearly 800 patients, with researchers saying that Mild to Severe depression might be better treated with alternatives to antidepressant drugs, which do not help patients much more than an inactive placebo.

They combined data from six studies that examined the effectiveness of two commonly prescribed antidepressants - paroxetine and imipramine. Results from these studies suggest the drugs produced benefits only slightly greater than a placebo in patients with mild to severe depression. Paroxetine is one of a popular class of drugs, selective serotonin re-uptake inhibitors (SSRI's), and is sold under the brand name Paxil by GlaxoSmithKline. Imipramine is an older tricyclic antidepressant drug developed in the 1950s. The so-called placebo effect is powerful in treating depression, where people believe they are helped even though they are taking an inactive sugar pill.

Using a scoring system for depression where a diagnosis of 24 or above indicates a very severe case, the researchers said patients treated with drugs saw their scores drop by 13 points, compared to a drop of 9 points for those given a placebo.

But for those with initial depression scores of 23 or below, the drop averaged 8 points for those given antidepressants and 7 points for those given a placebo. Roughly half of those prescribed antidepressants fit into the mild to severe categories.

However for people diagnosed with very severe depression the drugs' impact was noticeably stronger than a placebo.

Dr DeRubeis, one of the authors of the research, commented that doctors and patients should pause before prescribing antidepressants, and give consideration to other alternatives.

Exercise has been shown to be helpful to stem depression, as does psychotherapy, and even ''self-treatment'' with the aid of the plethora of self-help literature, he said.

In our practice here in Christchurch we find that clients are often not sure about starting on antidepressant medication and our recommendation (for clients with mild to moderate depression) is to try psychotherapy for a while, and see what the benefits are. Your therapist can monitor your progress and help you assess whether medication is required, in conjunction with your doctor.

www.reuters.com/article/idUSTRE60454020100105