What is the controversy behind antidepressants? This is where this new study steps in, attempting to draw conclusions about the overall efficiency of antidepressants.
"Patients should be aware of the potential benefits from antidepressants and always speak to the doctors about the most suitable treatment for them individually", said the researcher, who examined tests where some patients had been given antidepressants and others placebos.
Prof Carmine Pariante, from the Royal College of Psychiatrists, hopes that the in-depth research will lay to rest claims that antidepressants are ineffective.
The study also found that some kinds of antidepressants were more effective than others. However, there was a big variability in how well they fared.
Through examining trials involving almost 120,000 people, including patients taking 21 commonly prescribed antidepressants, the research found all the drugs were more effective than a placebo.
Professor Hopwood said the study showed that "all of the commercially-available antidepressants in Australia are more effective than placebos". "Some antidepressants were more effective than others, with agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine proving most effective, and fluoxetine, fluvoxamine, reboxetine, and trazodone being the least effective", write the authors of the newly-published Lancet paper.
The importance of addressing depression can not be overstated.
But she said Global Positioning System should try to offer patients talking therapies, so they did not end up becoming "reliant on medication".
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Depression affects around 300 million people across the world, according to the World Health Organisation.
Although important, these results do not answer the question about the long-term effects of antidepressants, and a network meta-analysis approach can not be used on the individual patient level, Sagar V Parikh, MD, department of psychiatry, University of MI, and Sidney H Kennedy, MD, department of psychiatry, University of Toronto, wrote in an accompanying comment.
The debate over antidepressants has unfortunately often been ideological, said Cipriani. The design of the network meta-analysis and inclusion of unpublished data is meant to reduce the impact of individual study bias as much as possible. Overall, 9% of the trials included in this meta-analysis were considered as high-risk of bias, 73% as moderate and 18% as low.
Furthermore, several previous trials have cast serious doubts on antidepressants (at least some of them).
As well as the usual database searches for published trials, the researchers went to some lengths to find unpublished data, for example checking websites of pharmaceutical companies, trial registers and licensing authorities, and requesting unpublished information from all pharmaceutical companies marketing antidepressants, to ensure nothing was missed. Some people suspect drug companies of fiddling trial results.
To make things even more complicated, different people have different problems and experience different results, that's why we have more than one antidepressant in the first place. The majority of the most effective antidepressants are now off patent and available in generic form. If you are taking an antidepressant and feel that it is working, this study is reassuring.
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.
"Antidepressants are an effective tool for depression". However, this does nothing to diminish the merit of the study. The choice will be need to made by doctor and patient'.