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Depressing news

Millions of people suffering from mild to severe depression recently heard that the pills they are taking are no better than placebo in treating their condition. This news story was based on a meta-analysis, published in PLoS Medicine, of a large number of clinical trials that resulted in the licensing of four of the most commonly prescribed antidepressants: the selective serotonin reuptake inhibitors (SSRIs) Prozac, Seroxat, Effexor and Serzone. One of the authors, Irving Kirsch, summed up their findings by saying “There seems to be little reason to prescribe anti-depressant medication to any but the most severely depressed patients...” ( Guardian.co.uk , 26 February 2008.)

Indeed, the publication of this article has raised concerns about the efficacy of these drugs. David Healy, a psychiatrist at Cardiff University, UK, says that “... [this] study confirms suspicions that the drugs' effectiveness had been dramatically overstated.” ( NewScientist.com , 26 February 2008.)

The pharmaceutical industry has defended the use of SSRIs. Richard Turner, from the Association of the British Pharmaceutical Industry, states that “These medicines have been licensed by a number of regulatory authorities around the world who, looking at all the evidence, have determined that they do work better than placebo.” ( BBCNews , 26 February 2008.)

Further in-depth analysis of the data that looks beyond the initial 6-week trial period covered by the study is required. However, these findings, together with the notion that some doctors seem all too ready to prescribe 'happy pills', has intensified the call for non-pharmaceutical treatments. Andrew McCulloch of the Mental Health Foundation says “We have become vastly over-reliant on antidepressants ... talking therapies, exercise referral and other treatments are effective for depression.” (BBCNews, 26 February 2008.)

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Wiedemann, C. Depressing news. Nat Rev Neurosci 9, 252 (2008). https://doi.org/10.1038/nrn2369

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