Study: Antidepressants most effective for severe depression

Jan 6, 2010 11:48 AM

Antidepressants provide the greatest benefit in people who are very severely depressed but may be no better than placebo in those with mild to moderate depression. That’s the conclusion of a new study released Tuesday in the Journal of the American Medical Association. The findings could have important implications given that the majority of people who are prescribed antidepressants do not have severe depression and thus may not be getting much, if any, benefit from the medications.

In the study, researchers conducted a meta-analysis (combining several studies into one analysis) to gauge the benefit of antidepressants compared to placebo. They included data from six trials involving 718 adults with depression.

The authors found that antidepressants showed little or no benefit over placebo in people with mild, moderate, or even severe depression. But the antidepressants brought considerable relief to those with very severe depression.

The researchers also note that studies supporting the effectiveness of antidepressants generally included only people with more severe depression, and excluded those with milder forms. However, this key piece of information is often left out of advertising for antidepressant drugs that targets both consumers and doctors.

The advertising issue is particularly concerning, because drug manufacturers do so much of it: Between 1999 and 2005, pharmaceutical companies nearly quadrupled the amount of money they spent on consumer advertising alone for antidepressants—jumping from $32 million to $122 million during that time. And it seems to have worked: Antidepressant use has nearly doubled in the United States since the mid-1990s.

While use of these drugs has skyrocketed, the flip side of this is, as we note in a recent Consumer Reports Best Buy Drug report on antidepressants: 60 percent to 70 percent of people with depression still don’t actually receive the treatment they need. This can include psychotherapy, which can be used in conjunction with medication and can also effectively relieve depression on its own in some cases. Some studies show that people treated with antidepressants are increasingly less likely to see a psychotherapist or psychiatrist, but given today’s findings, people with mild to moderate depression may choose to speak to their mental health professional or doctor about whether psychotherapy is appropriate for them.

—Steve Mitchell, associate editor, Consumer Reports Best Buy Drugs

For more information about antidepressants, check out our free Best Buy Drug report on the medicines and find out which treatments work best for depression (subscribers only).

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