Research on the Effectiveness of Antidepressants
Randi Fredricks, Ph.D.
As a therapist, I have a lot of clients ask me my opinion my medication for depression treatment. I tell them about a 2008 review of previous research uncovered via the Freedom of Information Act determined that revealed that four of the most commonly prescribed antidepressant medications, including Prozac, worked no better than sugar pills for mild to moderate.
The researchers learned that the drugs were only effective for very depressed patients. In people with lower levels of depression, the results of the antidepressants were quite modest or disappeared entirely. For the study, researchers analyzed 47 clinical studies conducted by pharmaceutical companies that were never released.
It included studies on depression treatment submitted to the FDA during the drug approval process, but not published in medical journals. The studies involved four drugs: fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone), and paroxetine (Seroxat/Paxil).
Research Suggests Antidepressants Over-prescribed
Approximately 118 million prescriptions are written for these and other antidepressants in the United States each year; that’s one prescription for every 2.5 Americans. In the U.K., an estimated 3.5 million people take antidepressants.
According to Blair T. Johnson, a depression treatment researcher at the University of Connecticut, “The implications from this research is that antidepressant medications are over-prescribed and people should probably try other options before they consider the medications.”
Other studies have had similar findings. In a 2002 Washington State study, investigators looked at 52 studies of antidepressants in the FDA’s database and determined that in 48% of the studies the results were no better than placebo. They also concluded that antidepressants were only more effective that sugar pills with the severest forms of depression.
Another study on depression treatment funded by the National Institute of Mental Health concluded that antidepressants worked very well for about a third of people; those with serious clinical depression, but not as well for others with mild to moderate depression.
In light of these findings, it’s important to remember that this large body of clinical research suggests that antidepressants do work in most cases of severe depression. This type of depression can include feelings of suicidality, making immediate treatment essential. In these cases, an evaluation by a mental health care professional is needed to determine the appropriate course of action.
How Long Can Antidepressants Be Taken?
There’s more: research has found that antidepressant users have a roughly 42% chance of a relapse, as compared with a 25% chance for those who shun antidepressant pills. Based on this, some doctors believe that while antidepressant medication is appropriate for very severe cases of depression, they shouldn’t be taken for more than a year.
There are other concerns about long-term antidepressant use. According to findings in a meta-analysis of 17 studies that was published in 2017 in the journal Psychotherapy and Psychosomatics people who used antidepressants had a 14% higher risk of heart attacks and strokes and a 33% greater risk of death. The risks appear to climb as people age. In older adults, SSRI medications are associated with falls, fractures and dementia. This information will no doubt cause many people to seek alternatives
Because antidepressants are effective for severe depression, the incidence of suicide has decreased significantly since the introduction of these drugs. What these studies do suggest is that antidepressants tend to be no more effective than placebo for mild to moderate depression, leading the researchers to suggest that non-drug approaches such as diet, exercise and psychotherapy may be more beneficial.
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Wang C, Gao S, Hendrie HC, et al. (2016). Antidepressant Use in the Elderly Is Associated With an Increased Risk of Dementia. Alzheimer Dis Assoc Disord, 30(2), 99–104.
About the Author
Randi Fredricks, Ph.D. is a practicing therapist, researcher and author specializing in the treatment of anxiety, depression, addiction, eating disorders, and related disorders. Dr. Fredricks is a best-selling author of several books including Healing & Wholeness: Complementary and Alternative Therapies for Mental Health a 650-page compendium and landmark publication that provides a comprehensive overview of complementary and alternative treatments for mental health, with information and research on their effectiveness for treating specific disorders. For more information on Dr. Fredricks work, visit her practice website www.DrRandiFredricks.com.