Are Antidepressants Really No Better Than Sugar Pills?

New findings that some popular antidepressants may be ineffective have left millions of patients wondering what to do. Well, first, here's what not to do -- don't stop taking your medications on your own, and talk to your doctor about treatment options.

A team of scientists has made headlines and sparked an uproar by reporting that four antidepressants are little better than placebos (sugar pills) for all but the most severely depressed patients. The four medications studied were fluoxetine (Prozac), paroxetine (Paxil), venlafaxine (Effexor) and nefazodone (sold in some generic versions in the United States but as Serzone abroad).

The British, American and Canadian researchers examined newly released data from clinical trials reviewed by the U.S. Food and Drug Administration (FDA). "Compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression, but show significant effects only in the most severely depressed patients," the researchers wrote in the journal PLoS Medicine.

The lead researcher, Irving Kirsch of the University of Hull, stated: "Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great. This means that depressed people can improve without chemical treatments."

However, drug companies say the review is flawed. GlaxoSmithKline, the maker of Paxil, stated: "Contrary to what has been reported, this study has only examined a small subset of the total data available for antidepressants. With paroxetine for example, this study only considers data from 16 trials out of a total database of more than 170 trials involving at least 14,000 patients."

The American Psychiatric Association (APA) said the study showed the importance of individualizing treatment. "Medication helps some, but not all people with depression. For people with mild to moderate depression, psychotherapy can work as well as medication," said Dr. Nada Stotland, APA president-elect.

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