Major study: more should take anti-depressants

Epidemic: Every year in the UK about one in four people will experience a mental health problem.

Has the debate finally been settled? A major study has come out in full support of antidepressants. But sceptics remain unconvinced, and say that we are in danger of medicalising sadness.

Scientists say they have settled one of the biggest debates in medicine after a huge study found that anti-depressants really do work.

The study, which analysed data from 522 trials involving 116,477 people, found 21 commonly used anti-depressants were all more effective at reducing symptoms of depression than dummy pills. The authors of the report recommended that many more people could benefit from anti-depressant prescriptions.

The report also identified huge differences in effectiveness between different anti-depressants, with agomelatine and amitriptyline showing the best results, and fluoxetine and fluvoxamine the worst.

Some previous trials had suggested that anti-depressants worked no better than placebos, but this so-called meta-analysis has united much of the medical community. The Royal College of Psychiatrists said the study "finally puts to bed the controversy on anti-depressants".

This assertion, though, is likely to be misguided, whatever the science says.

Prescriptions of anti-depressants have more than doubled in the last decade. This has a positive side, as it suggests that as the stigma has decreased, people have become more willing to ask for help. However many express concern about our growing dependence.

Key to arguments around antidepressant use is differentiating "normal" sadness from clinical depression. This is very difficult, as clinical depression is often triggered by real-life tragedies. There are clear links, for example, between unemployment and depression.

But some sense a deeper problem with society’s attitude to all this. Writing for The New English Review, conservative psychiatrist Theodore Dalrymple sees anti-depressants as an example of a modern, irresponsible attitude to life.

He writes: “I think there is an intangible harm to seeing life as a technical problem to be solved by neurochemical manipulation, namely that is unrealistic, crude, uncivilised and ultimately cruel.“

Is this “scientistic view of human behaviour” the right way to treat the rising evil of depression?

The perfect cure?

Society must become comfortable with antidepressants, say some. Scepticism of anti-depressants, especially those with huge proven benefits, will only increase the stigma surrounding mental health, resulting in more people suffering silently. It does not matter how somebody beats depression; it simply matters that they do.

“Illusion and disillusion spring eternal in the human breast,” writes Dalrymple. Anti-depressants symbolise our tortured attitude to life, where everything must be perfect and every solution must be easy. Instant gratification is a dangerous thing, as it distracts people from self-improvement and introspection.

You Decide

  1. Are anti-depressants the best way to cure depression?
  2. Do you think there is a social stigma attached to mental illness?

Activities

  1. List three pieces of advice you might give to someone who thinks they are suffering from depression.
  2. Do some research into the language the media uses about mental illness: what effect does it have?

Some People Say...

“Depression, suffering and anger are all part of being human.”

Janet Fitch

What do you think?

Q & A

What do we know?
A major new study has found that anti-depressants are sometimes extremely effective at curing depression. Some drugs are better than others. Lead researcher Dr Andrea Cipriani, from Oxford University, said: "This study is the final answer to a long-standing controversy about whether anti-depressants work for depression.” However, many remain sceptical of their long-term benefits.
What do we not know?
There are still many unanswered questions and unsolved problems about depression. For example, the model for depression that has been accepted for decades counts it as a brain disorder, and brain disorders are rooted in genetics. But no genes for depression have ever been discovered.

Word Watch

Dummy pills
In these trials, one group of people are given real anti-depressants, while another are given pills that have no effect at all. The groups are not told which is which. Often those who took the dummy pills, believing they were given the real thing, exhibit similar results to anti-depressants. This is called the “placebo effect”, and frequently confuses medical research.
Agomelatine
The drug is sold under several brand names, including Valdoxan, Melitor and Thymanax. It scored highly for “efficacy and tolerability”, although the two most effective drugs – amitriptyline and venlafaxine – might still be first choice for more severe forms of depression
Stigma
In recent years several well-known people have spoken out against society’s attitude to depression, including Selena Gomez and Miley Cyrus.
Unemployment and depression
A study in 2015 found that unemployment causes 45,000 suicides a year worldwide.

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