This week an article in the Lancet has shed light on the controversy surrounding antidepressants. Psychiatric disorders account for 22.8% of the global burden of disease, of which depression is the leading cause. In 2016 there were over 64 million prescriptions issued for antidepressants, which is more than double the amount issued ten years previously. Until now there has been much debate regarding the effectiveness of antidepressant drugs in treating this debilitating disorder. This study has been pivotal in providing evidence in addressing this controversy, as previous studies have not adequately examined the long term effects of antidepressants.
The study looked into 522 trials involving 116,477 patients and found that all antidepressants investigated were more effective than placebo. However, they weren’t all equally effective: It found that the drugs ranged from being a third more effective than a placebo to more than twice as effective. Interestingly, the findings showed that escitalopram, mirtazapine, paroxetine, agomelatine, and sertraline were the most efficacious in adult patients. On the other hand, reboxetine, trazodone, and fluvoxamine were found to be the least effective of the drugs tested, with effects diminishing over time. Many patients stop using antidepressants after only a few weeks, which may have contributed towards skewed results in previous investigations as many of the drugs tested are only effective after long term use. However, researchers noted that most of the data in the meta-analysis covered eight weeks of treatment, although it did not take into account problems that may emerge from longer term us of the drugs.
Overall, clinicians consider this study to be an important piece of evidence in encouraging patients to pursue treatment options for depression, including antidepressants where necessary. Hopefully, this seminal article will help remove the stigma surrounding depression and the use of antidepressants. More than ever, mental health is being acknowledged as a topic for serious discussion and in light of this article more awareness needs to be made about the treatment options for these disorders which affect one in four adults in the UK.
Blog written by Rachael Besser
1 Cipriani, Andrea et al. 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
2 McManus, S., Meltzer, H., Brugha, T. S., Bebbington, P. E., & Jenkins, R. (2009). Adult psychiatric morbidity in England, 2007: results of a household survey. The NHS Information Centre for health and social care.