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New generation anti-depressants have little clinical benefit for most patients, a recent study suggests. A BBC News article reports on the findings of a University of Hull team who reviewed data on 47 clinical trials. They concluded “the drugs helped only a small group of the most severely depressed.” The makers of Prozac and Seroxat, two of the commonest anti-depressants, said they disagreed with the findings.

One of the main authors of the research is Professor Irving Kirsch. Kirsch has published 8 books, 40 book chapters, and more than 175 scientific journal articles on placebo effects, antidepressant medication, hypnosis, and suggestion.

The meta-analysis concluded that the overall effect of the new generation of anti-depressants was below the recommended threshold used to determine clinical significance. The apparent good results for very severely depressed patients, they reported, came from the fact a patient’s response to the placebo decreased rather than any notable increase in their response to the treatment.

What Do These Findings Mean? These findings suggest that, 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

Anti-depressant tablets

most severely depressed patients. The findings also show that the effect for these patients seems to be due to decreased responsiveness to placebo, rather than increased responsiveness to medication. Given these results, the researchers conclude that there is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective.

Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. (PDF 222KB)

As always, if you have any concerns regarding your medication, we recommend discussing these with your doctor, rather than making any changes to your medication on your own.

February 2008
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