HomeLifestyleHealth & FitnessAntidepressants are no better than sugar pills, Doctor warns

Antidepressants are no better than sugar pills, Doctor warns

Published on

The outcomes that matter to patients are rarely assessed in trial data. Withdrawal symptoms are prevalent, severe, and long-lasting, says doctor.

A review of the evidence on antidepressant use published online in the Drug and Therapeutics Bulletin suggests that doctors should prescribe fewer antidepressants for shorter periods of time due to ongoing uncertainties about their effectiveness and the potential severity and durability of the withdrawal symptoms associated with them.

According to the authors, the use of antidepressants is also associated with a variety of adverse effects, and clinical trial data typically do not examine the outcomes that are most important to patients. Furthermore, there is no clinically significant difference between these drugs and placebo on depression.

While antidepressants may have a function in people with severe depression, the drawbacks may outweigh the benefits in those with mild to moderate depression or whose symptoms may not yet classify as depression, they say.

Antidepressant prescribing has consistently increased in England, with an estimated 7.8 million people receiving at least one prescription in 2019-20, mostly for the younger generation classes—selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).

This is equivalent to an antidepressant prescribed to one in every six adults, with prescription rates 50% higher among women.

The majority of the evidence for the efficacy of antidepressants in adults comes from 6- to 12-week placebo-controlled trials. According to the authors, the data do not meet the criteria for a clinically significant difference.

The results among adolescents and youngsters are much less impressive. Despite this, the number of 12- to 17-year-olds prescribed antidepressants more than doubled between 2005 and 2017, according to the researchers.

Furthermore, most studies exclude outcomes that are important to patients, such as social functioning or quality of life, instead of focusing solely on symptom measures.

Side effects are common as well. One in every five SSRI patients reports daytime sleepiness, dry mouth, profuse perspiration, or weight gain; at least one in every four reports sexual difficulties; and one in every ten reports restlessness, muscle spasms or twitching, nausea, constipation, diarrhoea, or dizziness.

Side effects may be more common in persons who have been taking antidepressants for more than three years, and might include emotional numbness and mental ‘fogginess.’

Patients attempting to quit therapy frequently experience withdrawal symptoms, which can include anxiety, sleeplessness, sadness, agitation, and appetite changes, and can interfere with social functioning and professional life, especially if treatment is abruptly discontinued.

“The recognition that withdrawal effects from antidepressants are more common, more long-lasting and more severe than previously recognised prompted the Royal College of Psychiatrists to issue a position paper, alerting prescribers to this issue, including the recommendation that patients be informed of this risk,” write the authors.

Gradual dose reduction may be the most effective method for patients to quit, the authors write, although “there is no guarantee that patients will avoid consequences such as long-lasting sexual side effects or persistent withdrawal symptoms even with a cautious taper.”

But they point out: “The gradual reductions in dose and the very small final doses required for pharmacologically informed tapering will necessitate the use of formulations of medication other than the commonly available tablet forms.”  

Patients attempting to stop antidepressant use, particularly long term users, may very well need additional help, say the authors. But “there are currently no dedicated NHS services to support antidepressant de-prescribing,” they add.

They conclude: “There continues to be considerable uncertainty about the benefits of antidepressant use in the short- and long-term, particularly in regard to the lack of a clinically significant difference between antidepressant and placebo treatment.

 “In light of this uncertain balance of benefits and harms, we should re-visit the widespread—and growing—prescription of antidepressants.”

They go on to say: “Increasing knowledge about the difficulty that some patients have in stopping antidepressants should lead to more cautious prescribing practice—with antidepressants given to fewer patients, for shorter periods of time.”

Source: 10.1136/dtb.2020.000080

Image Credit: Getty

You were reading: Antidepressants are no better than sugar pills, Doctor warns

Latest articles

Here’s How and When Mount Everest-sized ‘Devil Comet’ Can Be Seen With Naked Eye

Mount Everest sized Comet 12P/Pons-Brooks, also known as "devil comet" which is making its...

Something Fascinating Happened When a Giant Quantum Vortex was Created in Superfluid Helium

Scientists created a giant swirling vortex within superfluid helium that is chilled to the...

The Science of Middle-aged Brain and the Best Thing You Can Do to Keep it Healthy, Revealed

Middle age: It is an important period in brain aging, characterized by unique biological...

Science Shock: Salmon’s Food Choices Better at Reducing Risk of Heart Disease and Stroke

Salmon: Rich in Health Benefits, Yet May Offer Less Nutritional Value - This is...

More like this

Here’s How and When Mount Everest-sized ‘Devil Comet’ Can Be Seen With Naked Eye

Mount Everest sized Comet 12P/Pons-Brooks, also known as "devil comet" which is making its...

Something Fascinating Happened When a Giant Quantum Vortex was Created in Superfluid Helium

Scientists created a giant swirling vortex within superfluid helium that is chilled to the...

The Science of Middle-aged Brain and the Best Thing You Can Do to Keep it Healthy, Revealed

Middle age: It is an important period in brain aging, characterized by unique biological...