Financial Times FT.com

Study casts doubt on anti-depressants

By Salamander Davoudi

Published: February 25 2008 19:25 | Last updated: February 25 2008 19:25

Prescribing anti-depressants to the vast majority of patients is futile, as the drugs have little or no impact at all, according to researchers.

Almost 50 clinical trials were reviewed by psychologists from the University of Hull who found that new-generation anti-depressants worked no better than a placebo – a dummy pill – for mildly depressed patients.

Even the trials that suggested some clinical benefit for the most severely depressed patients did not produce convincing evidence. Professor Irving Kirsch from the university’s pyschology department said: “The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.

“This means that depressed people can improve without chemical treatments. Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients.”

The researchers focused on four widely prescribed anti-depressants and the clinical trials that were submitted to win licensing approval from the US Food and Drug Administration.

The drugs included fluoxetine (Prozac), venlafaxine (Efexor), and Paroxetine (Seroxat).

All belong to a family of drugs known as Selective Serotonin Reuptake Inhibitors (SSRIs). These drugs have become popular over the past 15 years as doctors consider them to be safer than tricyclic drugs that carried a high risk of overdose. In 2006, 31m prescriptions for anti-depressants were issued in England, up 27 per cent since 2001.

Alison Cobb, policy officer at mental health charity Mind, said: “This study represents a serious challenge to the predominance of pharmacological treatments for depression. Anti-depressants have been shown to help many people, but by no means all.”

“Too many GPs are being forced to dish out drugs because they don’t have proper access to psychological therapies services which are recommended by Nice.”

Mind is urging GPs to consider alternative therapies such as exercise – particularly outdoor exercise – which it believes has shown to be very effective in combating depression.

However, Dr Gary Bell, consultant psychiatrist at Capio Nightingale Hospitals, the provider of private psychiatry treatment, contested the conclusions of the Hull research. “Anti-depressants are one of the great breakthroughs in the treatment of depression in last 20 to 30 years,” he said.

“They do not always suit everybody but the results are often life-saving. People who do studies do not have the hands-on experience of using these medicines.”

According to the Royal College of Psychiatrists, at least one person in five will suffer from a depressive illness at some point.