Doctors have conducted a new systematic analysis of the effectiveness of antidepressants. According to their findings, such medications do help fight depression, although their effectiveness is not uniform. An article with the results was published in the Lancet .
Depression is becoming the most common cause of disability in the world, affecting 350 million people, an increase of 20% between 2005 and 2015. At the same time, only every sixth patient in developed countries receives the correct treatment, and in poor countries only one in 27. Scientists conclude that millions of people should be prescribed either medication or some form of psychotherapy.
“Antidepressants are effective at fighting depression,” says first author Andrea Cipriani of the UK’s National Institute for Health Research. “Untreated depression is a huge problem because of the burden on society.” The problem is also compounded by the fact that many patients and doctors are skeptical about antidepressants: in some studies, their effectiveness is not much higher than that of placebo; some believe that pharmaceutical companies are conducting unfair tests; some patients refuse to take mental health pills.
The new work took six years and includes all the available data on studies of the comparative effectiveness of antidepressants in pairs with a placebo or with each other – there were more than 500 such studies. The total number of patients exceeded 116 thousand people. It was possible to obtain data on 21 antidepressants. The most famous drug of this class – Prozac , which after the expiration of the patent is often called fluoxetine – turned out to be one of the least effective. On the other hand, its tolerability was found to be very high: this was measured by the proportion of courses completed and the reported side effects. The most effective was amitriptyline, which became the sixth in the list of tolerances.
Comparison of the effectiveness of some antidepressants and placebo. One means the same efficiency.
The Lancet / Oxford University
The situation with antidepressants is further complicated by the fact that in many cases the mechanism of their action is not completely clear. Most of them can be classified as selective serotonin reuptake inhibitors. It is believed that they should cause an increase in the amount of the neurotransmitter serotonin in the brain, but there is no absolutely accurate data on this. Scientists attribute the merits of the new work to the fact that it takes into account unpublished data from their own studies of pharmaceutical companies. The analysis showed that sponsorship by drug manufacturers did not affect the conclusions of such studies, which contradicts the view that such results are lobbied .