Antidepressants have been prescribed to people with depression varying widely on a scale of severity. The constant complaint by most individuals is that the drugs simply do not work. Well, perhaps these people were right in the first place.

The latest study reveals that drugs for depression only provide relief in individuals with severe depression. For the majority of other patients with moderate depression, the drugs were no more effective than a sugar pill.

While the drugs may help some individuals with depression, it appears that the overall benefits of these drugs have been exaggerated in the past. The problem in the past has been that most of the trials were sponsored by the pharmaceutical companies. We now know that these companies (e.g. like Pfizer) have no qualms about fudging the data.

Looking back it appears that data showing that anti depressants did not work may have been hidden or never published. Antidepressants are a multibillion dollar business and no drug industry is going to release negative data because the name of the game is –money.

Says Dr Erick Turner, a psychiatrist from Oregon Health and Science University, “I think the study could dampen enthusiasm for antidepressant medications a bit, and that may be a good thing. People’s expectations for the drugs won’t be so high, and doctors won’t be surprised if they’re not curing every patient they see with medications.”

But Dr. Turner added, “The findings shouldn’t dampen expectations so much that people refuse to even try medication.”

The drugs evaluated in the present study include Paxil and imipramine. The researchers looked at 6 large drug trials which included 50 percent of individuals with severe depression and the rest with moderate symptoms. The study conducted by Drs Jay C. Fournier and Robert J. DeRubeis from the Univ of Pennsylvania, showed that only patients with severe depression benefited from drug therapy.

“We were able to give an overall estimate of effectiveness for the first time in this more moderate severity range, from 14 to 20 on the scale, in which there’s no question that doctors would likely consider prescribing medication,” Dr. DeRubeis said. The researchers now claim that the effects of other popular SSRIs like Lexapro and Prozac will not be any different.

The authors observed that for people who had moderate depression, the drugs were no better than a sugar pill. Moreover these patients also developed a number of prominent side effects from the drugs.

“The message for patients with mild to moderate depression,” Dr. DeRubeis said, “is, ‘Look, medications are always an option, but there’s little evidence that they add to other efforts to shake the depression — whether it’s exercise, seeing the doctor, reading about the disorder or going for psychotherapy.’ ”

JAMA Jan 2010