Antidepressants help with treatment of depression, study finds

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Image The most and least effective antidepressants were revealed

Professor Andrea Cipriani, who led the six-year review of worldwide research, said the findings were proof that antidepressants should be used more.

The latest study was a meta-analysis including 522 double-blind placebo/real antidepressant tests done between 1979 and 2016 which compared 21 commonly-used antidepressants or placebo.

However, she said: "This does not necessarily mean that antidepressants should always be the first line of treatment".

Millions of people take antidepressants for depression.

The debate over antidepressants has unfortunately often been ideological, said Cipriani.

Scientists say they have settled one of medicine's biggest debates after a huge study found that anti-depressants work. The researchers were also unable to tease apart differences among groups of people in the studies-for instance, how the drugs worked for people of different ages or gender. "Importantly, the paper analyses unpublished data held by pharmaceutical companies, and shows that the funding of studies by these companies does not influence the result, thus confirming that the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". "This turned out to be very important", wrote Kirsch in a 2014 paper. Some people suspect drug companies of fiddling trial results. "By bringing together published and unpublished data from over 500 double blind randomised controlled trials, this study represents the best now available evidence base to guide the choice of pharmacological treatment for adults with acute depression".

Dr Cipriani added that while anti-depressants are effective, they shouldn't always be the first option when it comes to tackling depression.

Accusations of bias on either side are unlikely to go away.

However, the doubts and controversy over antidepressants, allied to the difficulties in discovering new neurological drugs, have led to the drug companies quitting a field that once - after the launch of Prozac - looked likely to be very lucrative for them.

Most of the 522 studies analyzed were funded by pharmaceutical companies, and the researchers say that 9% were rated as having a high risk of bias.

Another challenge is the heterogeneous nature of depression patients, who respond differently to different antidepressants. The most effective were Agomelatine (sold under several brand names, including Valdoxan, Melitor and Thymanax), amitriptyline (Elavil), escitalopram (Lexapro), mirtazapine (Remeron), paroxetine (Paxil), venlafaxine (Effexor XR) and vortioxetine (Trintellix).

Their study, which examined 120,000 people in more than 500 trials across three decades, concluded emphatically that antidepressants do work. Still, it should be noted that different drugs have different impacts on individuals.

Finally, there's the issue of long-term effectiveness.

Researchers added that most of the data in the meta-analysis covered eight weeks of treatment, so the findings might not apply to longer-term use.

Professor Hopwood said many Australians still remain unconvinced about the potential benefits of antidepressants.

Drugs were deemed effective if symptoms were reduced in at least half of patients over two months. The Organisation for Economic Co-operation and Development found people in the United Kingdom take almost twice as many antidepressants as those in France, Italy or Holland, five times as many as those in Korea and eight times as many as in Latvia.

Prof Carmine Pariante, Institute of Psychiatry, Psychology and Neuroscience and spokesperson for the Royal College of Psychiatrists, said: "This meta-analysis finally puts to bed the controversy on antidepressants, clearly showing that these drugs do work in lifting mood and helping most people with depression". From a strictly scientific perspective, though, the evidence is pretty mixed.

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