Antidepressants are effective, right?
Feb 23, 2018 — If you live in the UK, no doubt you will have seen some of the extraordinary media reporting about antidepressants. If the headlines are to be believed, then the latest Lancet study into antidepressants should permanently end any doubt about their efficacy.
The Lancet study certainly made headlines, but as usual, the devil is in the detail.
There will be far more elegant critiques posted in response to the study, but there is one fact that the media doesn’t seem so keen to report on, which may change how we view this much-heralded study.
The study itself is not new work but reviews the outcomes of 522 placebo-controlled trials conducted over the last 37 years (between 1979 and 2016). In many of the studies reviewed, results (outcomes) were obtained at 8 weeks and no further.
This study may indicate that antidepressants have a beneficial, short-term effect, but we can’t tell anything about the benefit versus the risk over the longer term.
In the UK as a whole, we tend not to prescribe short courses of antidepressants, people are on them for many months, years, sometimes decades. The Royal College of General Practitioners recommends that antidepressant therapy is continued for at least six months. This study, unfortunately, tells us nothing that will be of benefit to prescribers or to patients given the way that we prescribe drugs for mental health.
Finally, as for the wild extrapolation that “up to a million more may benefit from the drugs” as widely reported, the data in the Lancet study does not back that conclusion up in any way.
Whatever the study reports, or the debate that goes on around it, none of that diminishes the power of your own experiences with these drugs. Whether you felt they helped or harmed you, you are the expert in your own experience.
For those not in the UK, here are links to a few of the media items from yesterday and today:
Firstly, the full study itself: Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis
From the Times: More people should get pills to beat depression
The Guardian: The Drugs Do Work, Antidepressants Are Effective Study Shows
And Guardian columnist, Mark Rice-Oxley: It’s Official, Antidepressants are not Snake Oil or a Conspiracy, They Work
The Daily Mail: John Naish disagrees with Antidepressant Study
New Scientist: Almost Every Antidepressant Headlines You’ll Read Today Is Wrong
A brief response from Professor Peter Gøtzsche: Cipriani Review does Not Add Anything New
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