It is Only the Most Depressed who Benefit from Anti-depressants

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A new study has shown how it is only the most depressed people who benefit from antidepressant medication. The UK study has made the suggestion that antidepressants are no more useful than a placebo in those people who are anything other than very depressed.

It was a meta-analytical study which systematically pools other studies results. The key man in the studies undertaking was one Dr Irving Kirsch from Hull University. He allowed his findings to be published in PLoS Medicine.

Amongst the antidepressants used in clinical depression treatment the most common ones used are SSRI’s like Prozac and Effexor, these are called in the study “new generation” drugs.

The study uncovered that just as had been noted as a possibility from other meta-analytical studies, when you include the findings of unpublished trials there is barely any difference for the majority of users of these antidepressants, than were they to be on a placebo only. The differences are so small that they fall out of clinical significance.

This was evident from previous studies of this type, but what was never covered to this point was the level of depression a patient needs to be suffering from before an impact is realised from taking the drugs. All of the data that has been administered to the FDA was pooled by the UK researchers with regards to this “new generation” of drugs. The fact that the study included unpublished trials was significant. By this means a bias was avoided, as many drug companies cover up their trials and do not publish them when the results show disappointing results for their drugs.

The serotonin reuptake inhibitors that are the “new generation” of drugs work by stabilising the chemicals in our brains, ones that are known to influence our moods. They make more serotonin available to assist with mood. The results found determined that: Drug-placebo differences were seen to heighten as the severity at the point of beginning went up. Also the variation in result was barely noticeable when the initial depression was at moderate levels.

There was however a relatively small amount of difference in results for patients with severe depression. The differences however were only of a clinically important level when these ‘new generation’ drugs were used in the treatment of patients at the extreme end of the depressed scale.

The professors made the deduction in their research that; “Drug-placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients.” They also stated that, “The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.”

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