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New research says anti-depressants can be a waste of time - let us know what you think
A review of clinical trials found they worked no better than a dummy pill for mildly depressed patients and for most people suffering severe depression.
Even trials suggesting benefit for severely depressed people did not provide evidence of clear clinical benefit, researchers said.
Dr Tim Kendall, deputy director of the Royal College of Psychiatrists Research Unit, said the findings were "fantastically important''.
A group of experts, led by Professor Irving Kirsch, from the Department of Psychology at the University of Hull, analysed 47 clinical trials using data
released under Freedom of Information rules by the US Food and Drug Administration (FDA).
Commonly-used antidepressants
The researchers looked at four commonly-used antidepressants and the clinical trials submitted to gain licensing approval.
They included antidepressants regularly prescribed in the UK, including fluoxetine (Prozac), venlafaxine (Efexor) and paroxetine (Seroxat).
They found little evidence of benefit when analysing both unpublished and published data from the drug companies.<
The researchers said their study was one of the most thorough investigations into the efficacy of new generation antidepressants, known as Selective Serotonin Reuptake Inhibitors (SSRIs).
The researchers concluded: "We find that the overall effect of new generation antidepressant medications is below recommended criteria for clinical significance."
Professor Kirsch said: "The difference in improvement between patients taking placebos and patients taking antidepressants is not very great.
"This means that depressed people can improve without chemical treatments. Given these results, there seems little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit.
"This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported."
Dr Kendall echoed the view that the study was important because it looked at both unpublished and published trial data.
In 2004, Dr Kendall and colleagues examined how drug companies only publish SOME of their data relating to new drugs.
Writing in The Lancet medical journal, they concluded that published evidence was more favourable than unpublished evidence when it came to looking at the safety of paroxetine and venlafaxine in children and young people with depression.
It was only when all evidence was examined that it was clear that the risks (particularly the increased risk of suicidal behaviour and thinking) outweighed the benefits for this group, Dr Kendall said.
The effect of placebo is large in trials looking at antidepressants and it is often difficult to tell if benefit is derived from the drugs or the placebo, he
added.
NICE (The National Institute for Health and Clinical Excellence) which is due to review its guidance on treating depression, said that it would consider the study.
Drug companies
A spokesman for GlaxoSmith Kline which makes Seroxat said: "The authors have failed to acknowledge the very positive benefits these treatments have provided to patients and their families dealing with depression and their conclusions are at odds with what has been seen in actual clinical practice."
A spokesman for Eli Lilly, which makes Prozac said: "Extensive scientific and medical experience has demonstrated that fluoxetine is an effective antidepressant."
GMTV's GP Dr Hilary Jones says he's surprised by the research: "There have been studies in the past which provided strong evidence of the effectiveness of these drugs.
"Antidepressants generally are the mainstay for treating depression - not all of those prescribed are in this group, older drugs are still used as well.
"The problem with the older drugs is that there's more problems associated with overdosing on them.
"How much notice we should take of this new research depends on the criteria of the various trials they've reviewed. Prozac especially has been very popular but may have been overprescribed, especially in the US.
"The best treatment for depression is always likely to be a combination of drugs and talking therapies."
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