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Daily Mail Online
Wednesday, Jan 22 2014
Anti-depressant tablets taken by millions of Britons may be a waste of time and money, research shows.
An analysis of dozens of studies involving thousands of patients revealed that some of the most widely-prescribed anti-depressants work little better than dummy pills.
The drugs studied – including Prozac, Seroxat and Effexor – were little more effective than placebos in improving the mental health in the majority of cases, the University of Hull research showed.
Only in the most extreme depression did the tablets, which are taken by around two million Britons and have been linked to a host of side effects including suicide, prove substantially superior in improving mental health.
Dr Tim Kendall, of the Royal College of Psychiatrists, described the results as “fantastically important”.
He added that one of the study’s strengths lay in the inclusion of data which drug companies had chosen not to publicise – perhaps because it was less favourable than they would like.
The study, published in the respected journal PLoS Medicine, suggests hundreds of thousands of Britons are needlessly taking powerful – and potentially dangerous – drugs.
As well as suicide and suicidal thoughts, side-effects associated with the drugs studied and other SSRI (Selective Serotonin Reuptake Inhibitor) anti-depressants range from self harm to anxiety, insomnia, nausea, headaches and vomiting.
Seroxat alone has been linked to at least 50 suicides – both adult and child – in the UK since 1990.
The research comes as prescriptions for anti-depressants are at record levels, with 31 million written in 2006 at a cost to the NHS of almost £300million.
Around half of these were for Prozac, Seroxat, Efexor and other SSRIs.
Researcher Professor Irving Kirsch said: “Given these data, there seems little evidence to support the prescription of anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide benefit.”
Professor Kirsch, a psychologist, reached his conclusion after combining the results of 35 clinical trials involving more than 5,000 patients with depression.
The data on Prozac, Seroxat, Efexor and a fourth drug not used in the UK had been submitted to the U.S. drug watchdog ahead of the antidepressants being licensed for sale.
Two-thirds of those taking part in the studies were prescribed the SSRIs, while the remainder took placebo tablets.
Comparison of the two groups showed that in the majority of cases the mental health of those taking anti-depressants improved little more than those on dummy pills.
Only those who were extremely depressed – a very small proportion of those studied – fared substantially better when on medication.
The results suggest that those taking the tablets mainly benefit from the “placebo effect” – in which symptoms are eased not by medication but by relief in diagnosis and the simple expectation a treatment will work.
Professor Kirsch emphasised that patients should not change their treatment without speaking to their doctor, but said other approaches include physical exercise, psychoanalysis and self-help books.
Richard Ley, the Association of the British Pharmaceutical Industry, the drug industry’s trade body, said all medicines have to be proven to be more effective than a placebo before they are put on sale.
A spokesman for the National Institute for Health and Clinical Excellence, which draws up guidelines on the treatment of illnesses, said routine use of anti-depressants is not recommended for mild depression.
He added that Professor Kirsch’s results would be taken into consideration when the existing guidelines are reviewed later this year.
How I ran off my blues
Hailed as a miracle cure for depression when they were first prescribed in the late 1980s, the “happy pills” known as SSRIs work by keeping the mood-boosting chemical serotonin in the brain for longer.
Kate Charles spent seven years on anti-depressant drugs after suffering severe depression as a teenager.
It was only when she took up running that she was able to stop taking the pills after finding that exercise was better at lifting her mood.
Speaking about her experiences three years ago, the 35-year-old writer from Dorset, said: “I have always felt quite low but my depression really hit when I was a teenager.
“By the time I was 15, my GP was prescribing beta blockers to relax my nerve impulses, slow my heartbeat down and make me feel calmer. Then, before my A-levels, I was put on anti-depressants.
“In my final year at Sussex University, my GP moved me on to Prozac, which was the wonder drug at the time.
“Although it improved the depression, I felt detached and numb. I had other terrible side-effects -painful, aching joints, sleeplessness and anxiety.
“Somehow, I managed to get a job in a finance company and struggled on but Prozac was my constant companion.”
Things changed when she set herself the challenge of training for a marathon.
She said: “Running was so much more effective at lifting my mood than Prozac that I consulted the doctor and spent eight months weaning myself off the drugs.
“The withdrawal was painful but I was determined. I have no doubt that running took me out of my depression.”