A massive study has shown that we need better treatments than antidepressants

(ORDO NEWS) — Antidepressants are the primary treatment for depression, but their use is clouded by questions about long-term effectiveness. A new study has found that antidepressants may not improve people’s quality of life in the long term compared to people with depression who do not take these medications.

This does not mean that we should not use them, because in many cases these drugs are life saving. But the results are the latest among a series of studies that are forcing us to reconsider attitudes towards antidepressants; this is an important project considering that millions of people around the world are taking them for depression.

The study, led by pharmacoepidemiologist Omar Almohammed of King Saud University, Saudi Arabia, may also help validate the experience of people who feel antidepressants have failed them.

For some, these drugs do little to relieve depression and can have unwanted side effects such as weight gain, insomnia, loss of sex drive, and even withdrawal-like symptoms if stopped abruptly.

Improving people’s overall well-being, especially their quality of life, for years, not just a few short months, is the “ultimate goal of therapy,” write Almohammed and colleagues in their paper. However, whether antidepressants help achieve this goal is questionable, to say the least.

The history of antidepressants is mixed, overly influenced by the pharmaceutical industry, which has been found to have long suppressed trial data showing that antidepressants can be ineffective, inflating the apparent effect of lucrative drugs.

While this publication bias seems to have abated in recent years, the fact remains that antidepressants leave many people desperate for better treatments, and the global burden of depression continues to rise.

Many studies also exacerbate the problem by not taking into account the aspects that matter most to patients, such as quality of life.

In the latest study, Almohammed and colleagues analyzed data from the Medical Expenditures Panel Survey, a nationwide study that tracks what medical services Americans use.

Medical records showed that, on average, between 2005 and 2016, approximately 17 million adults were diagnosed with depression each year—a staggering figure, equivalent to the population of the Netherlands or Ecuador.

About two-thirds of the people in the 11-year data set were women, reflecting real gender disparities in mental health; almost 60 percent were treated with antidepressants.

The use of antidepressants was associated with some improvement in mental but not physical aspects of quality of life, analysis showed. This means that people tended to report that their psychological distress and well-being improved after taking antidepressants, but physical health problems, bodily pain, and lack of vitality often remained.

It is worrying that the positive changes in some aspects of quality of life observed among those who took antidepressants for two years were not much different from those who did not take these drugs.

Physicians and healthcare professionals should consider getting people into psychotherapy or social support sessions before resorting to or prescribing antidepressants, “mainly because these drugs have not had a lasting effect” on people’s quality of life, the team writes.

However, the study did not distinguish between newly diagnosed cases of depression and people who had lived with the mood disorder for many years; people were included in the analysis if they had a diagnosis of depression and two years of follow-up.

This means that the possibility that for some these drugs had an initial effect before the two-year follow-up period cannot be ruled out.

The researchers were also unable to control for depression severity, as this was not captured in the study data. In addition, the two study groups differed somewhat in terms of age, gender, ethnicity, and poverty levels.

We also cannot extrapolate the results of this US-focused study to anyone and everywhere, but they are consistent with a growing body of evidence from other countries that current antidepressants do not work in many ways.

This does not mean that we should completely abandon antidepressants. Rather, as this study highlights, clinicians may need to rethink how best to use antidepressants and whether these drugs provide meaningful and lasting benefits to people.

For example, just last year, researchers argued that mental health professionals need to rethink who and how antidepressants are prescribed, that these drugs should be given for shorter periods of time, and for people with severe depression rather than mild symptoms.

Moreover, according to a 2016 meta-analysis of more than 150 randomized, placebo-controlled trials, the gold standard of clinical evidence, combining antidepressants with the support of a psychotherapist appears to be the key to improving people’s quality of life, more so than drugs or talk therapy alone. .

“While we still need to keep our patients with depression on antidepressants, long-term studies are needed to evaluate the actual impact of pharmacological and non-pharmacological interventions on the quality of life of these patients,” the team adds.


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