Only Severely Depressed Benefit From Antidepressants

And while I am writing about antidepressants today and the treatment of depression, let me mention here that antidepressants, while a great revenue enhancer for the pharmaceutical companies, don't seem to work beyond what one would expect from the placebo effect.

Reuters HealthDay reported on March 1, 2008 on a study which appears in the on-line journal, PLoS Medicine, on February 25, 2008 which found that antidepressants only helped in severe depression. They did not seem to have much of an effect beyond the placebo effect for mild and moderate depression.

Again, these are not new findings. Most of us in the mental health field have known this for years. Primary Care Physicians continue to prescribe antidepressants because it is an easy, quick way to respond to patient's complaints, and the pharmaceutical companies have plied Primary Care Phsysicians with plenty of free samples to give the physician and patient the illusion that there is a quick fix in popping a pill. Here's a snippet from the Reuters article:

While popular antidepressants such as Prozac are widely prescribed for people with varying degrees of depression, the drugs are only effective for those with the most severe depression, a new study suggests.

"Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great," lead researcher Irving Kirsch, a professor of psychology at the University of Hull in Great Britain, said in a prepared statement. "This means that depressed people can improve without chemical treatments," he added.

In the study, Kirsch and his colleagues collected data on 35 clinical trials of antidepressant drugs whose results had been submitted to the U.S. Food and Drug Administration. The antidepressants included in the trials were fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone), and paroxetine (Seroxat/Paxil).

An analysis of the data showed that patients taking antidepressants fared no better than patients receiving a placebo. This appeared to be the case whether the patients were mildly or moderately depressed.

The drugs only seemed to benefit a small group of patients -- those with the severest depression when the study began.

Based on these results, there appears to be little reason to prescribe these antidepressants to anyone but the most severely depressed patients, the study authors concluded.

The findings were published online Feb. 25 in the journal PLoS Medicine.

Brief cognitive behaviorally oriented psychotherapy is treatment of choice for mild to moderate forms of depression, and has been shown to be very helpful with medications and other treatments with severely depressed patients as well.

Link: MedlinePlus: Only Severely Depressed Benefit From Antidepressants: Study.