Antidepressants are a mainstay in treating depression, but their use is obscured by questions about lasting effectiveness. A new study now suggests that antidepressants may not improve people’s long-term quality of life, compared to people with depression who don’t take this type of medication.
This doesn’t mean we shouldn’t use them, as these drugs save lives in many cases. But the results The latest among a large body of work that has led to a rethink of antidepressants; An important project, considering Millions of people take it for depression around the world.
The research, led by pharmacological epidemiologist Omar Muhammad of King Saud University in Saudi Arabia, may help validate the experiences of people disappointed with antidepressants. For some, these medications 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 they are stopped suddenly.
Improving the general well-being of people, and especially their quality of life, for years and not just a few short months, is the “ultimate goal of treatment”, Mohamed and his colleagues write in their paper. However, whether antidepressants help achieve this goal It is questionable, to say the least.
Antidepressants have a checkered history, plagued by undue influence from the pharmaceutical industry, which turns out to have stifled trial data showing antidepressants can be ineffective, amplifying the obvious effects of profitable drugs.
Although this publication’s bias has waned in recent years, the fact remains that antidepressants leave many people in desperate need of better treatments, while the global burden of depression continues to grow.
Many studies also complicate the problem by not taking into account the aspects that are most important to patients – such as quality of life.
In this latest study, Mohamed and his colleagues examined data from the American Medical Expenses Panel Survey, a nationwide study that tracks health services Americans use.
Health records showed that, on average, between 2005 and 2016, nearly 17 million adults were diagnosed with depression each year, a staggering number equivalent to the population of the Netherlands or Ecuador.
About two-thirds of the people in the 11-year data set were women, reflecting realistic gender disparities in mental health; Nearly 60 percent were treated with antidepressants.
The analysis found that antidepressant use was associated with some improvements in mental aspects, but not physical aspects of quality of life. What this means is that people tended to report that their stress and well-being improved with antidepressants, but their physical health problems, physical pain, and lack of vitality often remained.
Alarming, positive change in some aspects of quality of life It was observed among those who took antidepressants over a period of two years and did not differ much from that observed among those not taking the medications.
The team wrote that clinicians and health professionals should consider referring people to psychotherapy or social support sessions before resorting to, or when prescribing, antidepressants “because there is no sustained effect of these medications” on people’s quality of life.
However, the study did not distinguish between newly diagnosed cases of depression and people who have lived with the mood disorder for years. People were included in the analysis as long as they were diagnosed with depression and two years of follow-up data. This means that the scenario that these drugs had an initial effect for some before the two-year period observed cannot be ruled out.
The researchers were also unable to control for the severity of depression because this was not recorded in the survey data. In addition, the two study groups also differed somewhat in age, gender, ethnicity, and experience of poverty.
We also can’t extrapolate the results of this US-centric study to everyone, everywhere, but they fit in with mounting evidence from other countries that modern antidepressants are in many ways inadequate.
This does not mean that we should eliminate antidepressants completely. Instead, as this study emphasizes, clinicians may need to rethink how best to use antidepressants and whether or not the drugs provide meaningful and lasting benefits for people.
For example, just last year researchers argued that mental health experts need to reconsider who and how antidepressants are prescribed, and that medications should be prescribed for shorter periods of time, and for people with severe depression, not mild symptoms.
What’s more, pairing antidepressants with the support of a psychotherapist appears to be key to improving people’s quality of life, more than medication or talk therapy alone, according to a 2016 meta-analysis of more than 150 randomized, placebo-controlled trials, the gold standard. From clinical evidence.
“Although we still need our depressed patients to continue using antidepressant medication, long-term studies evaluating the actual impact of pharmacological and non-pharmacological interventions on the quality of life of these patients are [are] need,” the team adds.
The study was published in PLUS ONE.