Many patients with depression continue to complain that the antidepressants they have been prescribed do not work. These individuals often go through many antidepressants, spending thousands of dollars only to find that most antidepressants either do not work of if they work, the effectiveness is only for a limited duration.
Why this is occurring is not well-understood, but it is believed that many antidepressants which have been previously evaluated in clinical trials have not been well-studied over all.
Secondly, it is also believed that the doctors who performed these trials were paid by the manufacturers of the drug and thus, clinical efficacy was not well-studied and the negative side effects were not published. (2)
Thirdly, it could be that the dose of the antidepressant prescribed is subtherapeutic.
Recently some researchers undertook a study to find out how antidepressant drugs compare to the active placebo in terms of efficacy. In this study, researchers looked at the active placebo which mimic side effects of antidepressants but has no antidepressant activity and compared it to the available antidepressant drugs.
The investigators studied 751 depressed participants and tried to match the two groups of patients -- one was given the real drug while the other was given the active placebo.
Shockingly, what they discovered was that the difference between antidepressants and the active placebo was very small. The conclusion was that the effects of the antidepressants are overestimated and the effects of placebo are underestimated. (2)
So what does all this mean for the consumer?
Some antidepressants do work and it is not recommended that consumers stop taking them. Unfortunately, until a good medication that works is available, patients should stick to what they have been prescribed. Antidepressants can be life-saving for some people.
For the depressed patient who is unable to find a medication to improve mood, rather than seek a drug, it is important to seek a good psychiatrist who can help you manage your illness.
1. Ulas H et al. Financial conflict of interest in clinical psychiatry studies: a review.