It seems that despite the efforts of big drug companies to mass market their antidepressants -- turning them into blockbuster druggs as they pitch the pills to children and pregnant women -- only the severly depressed actually benefit, a new study says.
The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.
Lead researcher Robert J. DeRubeis of the University of Pennsylvania said the study, published in the Journal of the American Medical Association, showed that those with only mild depression seemed to benefit from simply the added attention given to them by doctors during the drug trials -- and points to other ways such people can fight their depression.
“The message for patients with mild to moderate depression,” Dr. DeRubeis said, “is, ‘Look, medications are always an option, but there’s little evidence that they add to other efforts to shake the depression — whether it’s exercise, seeing the doctor, reading about the disorder or going for psychotherapy.’ ”
GlaxoSmithKline, the makers of Paxil, one of the drugs in the study, questioned the findings.
”The studies used for the analysis in the JAMA paper differ methodologically from studies used to support the approval of paroxetine for major depressive disorder, so it is difficult to make direct comparisons between the study results,” Glaxo spokeswoman Claire Brough said.
”Antidepressants are an important option, in addition to counseling and lifestyle changes, for treatment of depression.”
About 70 per cent of those taking such medications have mild enough depression that the medications may be of no use, the study found. The study could change how doctors approach depression with their patients, the New York Times said.
“I think the study could dampen enthusiasm for antidepressant medications a bit, and that may be a good thing,” said Dr. Erick H. Turner, a psychiatrist at Oregon Health and Science University. “People’s expectations for the drugs won’t be so high, and doctors won’t be surprised if they’re not curing every patient they see with medications.”
But Dr. Turner added, “The findings shouldn’t dampen expectations so much that people refuse to even try medication.”
The Star's mental health blogger, Sandy Naiman, also wrote about this study today, saying it "supports the strong contention I have about quick-fix, pill-popping approaches to mental health recovery."