Which antidepressants work best?

23 February, 2018, 06:26 | Author: Nina Hammond
  • Their study which examined 120,000 people in more than 500 trials across three decades concluded emphatically that antidepressants do work

The meta-analysis includes data on 116,477 patients total, from double-blind, randomized controlled trials published between 1979 and 2016.

Each of the 21 antidepressants was more viable than fake treatment, and just a single medication (clomipramine) less satisfactory than fake treatment.

What is the controversy behind antidepressants? Some had small impacts, while others were moderate, depending on the drug. The majority of the most effective antidepressants are now off patent and available in generic form. This is where this new study steps in, attempting to draw conclusions about the overall efficiency of antidepressants.

Antidepressants work - some more effectively than others - in treating adults with major depressive disorder, according to authors of a groundbreaking study which doctors hope will finally put to rest doubts about the controversial medicine.

The global team of researchers, led by Dr Andrea Cipriani (NIHR Oxford Health Biomedical Research Centre), searched through multiple databases to find any trials involving antidepressant therapies up until 8 January 2016. Importantly, the paper analyses unpublished data held by pharmaceutical companies, and shows that the funding of studies by these companies does not influence the result, thus confirming that the clinical usefulness of these drugs is not affected by pharma-sponsored spin. However, there was a big variability in how well they fared.

The study found that some medications were more effective than others.

In general, newer antidepressants tended to be better tolerated due to fewer side effects, while the most effective drug in terms of reducing depressive symptoms was amitriptyline - a drug first discovered in the 1950s.

Agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were found to be most effective, while fluoxetine, fluvoxamine, reboxetine, and trazodone were least effective.

The importance of addressing depression can not be overstated.

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If cancer or heart patients suffered this level of under-treatment, there would be a public outcry, they say.

An estimated 350 million people have depression worldwide.

The debate over antidepressants has unfortunately often been ideological, said Cipriani. However, the design of the meta-analysis and the inclusion of previously unpublished data attempted to reduce the impact of bias as much as possible. Among the trials, 9 percent were rated as having high risk of bias, 78 percent as having moderate risk of bias and 18 percent as having low risk of bias.

Furthermore, several previous trials have cast serious doubts on antidepressants (at least some of them). Pharmaceutical companies funds the majority of studies on antidepressants, and they have a clear financial interest in the success of these drugs.

It has been suggested that more than a million people per year in the United Kingdom should be given access to treatment for depression, through either drugs or talking therapies, with scientists saying the study proves that the drugs do work.

The findings contrast with a similar analysis in children and adolescents, which concludes that fluoxetine is probably the only antidepressant that is helpful for this age group.

Lastly, this review only analyzed results over a period of 8 weeks. Furthermore, the trials covered only short-term usage (eight weeks).

"Our study brings together the best available evidence to inform and guide doctors and patients in their treatment decisions".

Antidepressant drugs really do work, a major new worldwide study has proven.



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