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Study Questions Effectiveness of SSRI Antidepressants

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A study is questioning the efficacy of selective serotonin reuptake inhibitor (SSRI) antidepressants, finding them no better than placebos in many cases.

The meta-analysis of SSRIs, derived from information presented to the U.S. Food and Drug Administration (FDA) suggests that, generally, SSRIs do not work for most patients, said Biopsychiatry. A prior study revealed SSRI benefits could be exaggerated.

The team of U.K. and U.S. researchers, led by Irving Kirsch of Hull University, in the U.K., analyzed all of the clinical trials submitted to the FDA for the licensing of Prozac (fluoxetine), venlafaxine, nefazodone, and Seroxat and Paxil (paroxetine), four SSRIs for which full datasets were available, noted Biopsychiatry. The team concluded 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.”

Prozac and other SSRIs were considered no better than placebos in treating all but the most seriously depressed patients, but the effect is considered small “due to decreased responsiveness to placebo, rather than increased responsiveness to medication,” the team said, wrote Biopsychiatry. The team concluded that, based on these results, there is little point in prescribing SSRIs to any but the most severely depressed patients.

The new study confirms what researcher have long suspected, said David Healy, a psychiatrist at Cardiff University, U.K. and an SSRI specialist, that the antidepressants’ efficacy has been “dramatically overstated,” said Biopsychiatry. “Most importantly this new study shows that the people who did respond to the drugs would have responded to placebo anyway. It confirms that GPs should not be dishing these drugs out as first-line treatment for mild depression,” Healy told New Scientist. SSRIs are “routinely being given to people who would get better without them,” Healy added, wrote Biopsychiatry.

Kirsch, who is also Harvard Medical School’s Director of Placebo Studies and who has been studying placebos for 36 years, claims placebos can treat everything from irritable bowl syndrome, ulcers, Parkinson’s disease, and, now, mental health illnesses, said The Huffington Post. “The difference between the effect of a placebo and the effect of an antidepressant is minimal for most people. They’d have almost as large an effect and whatever difference there would be would be clinically insignificant,” Kirsch told CBS reporter, Lesley Stahl, on 60 Minutes, wrote The Huffington Post.

“But people are getting better taking antidepressants. I know them,” said Stahl. “People get better when they take the drug. But it’s not the chemical ingredients of the drug that are making them better. It’s largely the placebo effect,” Kirsh explained, according to The Huffington Post.

Michael Thase of the University of Pennsylvania told The Huffington Post that his research revealed that antidepressants help up to 14% of moderately depressed people and this figure increases significantly for patients considered severely depressed. While Thase and Kirsh disagree, it appears as if a placebo effect does exists and specifically n the less severe depression cases, said The Huffington Post. In the U.K., said The Huffington Post, the National Health Service (NHS) also found that SSRIs has little to no impact on patients suffering from mild to moderate depression.

New Scientist also reported that U.S. lawyers claimed to have obtained documents suggesting that an inappropriate analysis of clinical trial data conducted by GlaxoSmithKline researchers hid information on the suicide risks associated with Paxil for 15 years, said Biopsychiatry. Healy also pointed out that drug makers tend to release positive results data about SSRIs in the mildly depressed, wrote Biopsychiatry.

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