Drugs may be ineffective in treating depression, study says

NEW RESEARCH which shows that anti-depressants are relatively ineffective highlights the lack of funding for alternative forms…

NEW RESEARCH which shows that anti-depressants are relatively ineffective highlights the lack of funding for alternative forms of treatment, according to Irish mental health professionals.

It follows a review of clinical trials that found that such drugs had no more effect than a placebo for mildly depressed patients and for most people suffering severe depression.

The Irish Medicines Board said it would assess the new information and consider regulatory action if deemed appropriate.Researchers analysed 47 clinical trials using data released under Freedom of Information by the US Food and Drug Administration.

The researchers looked at four commonly-used anti-depressants and the clinical trials submitted to gain licensing approval, including fluoxetine (Prozac), venlafaxine (Efexor) and paroxetine (Seroxat).

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Their study, published yesterday in the journal Public Library of Science Medicine, found little evidence of benefit when analysing both unpublished and published data from the drug companies.

A spokesman for GlaxoSmithKline, which makes Seroxat, said: "The authors have failed to acknowledge the very positive benefits these treatments have provided to patients and their families dealing with depression, and their conclusions are at odds with what has been seen in actual clinical practice."

Eli Lilly, which makes Prozac, said extensive scientific and medical experience had demonstrated that fluoxetine has worked as an effective anti- depressant.

"Any time that research causes people to pause and reflect on the use of expensive medication, that's a good thing," said Dr Mel Bates, spokesman for the Irish College of General Practitioners.

"Ten years ago the talk was that GPs were not diagnosing enough depression, and there was concern that this was contributing to increased suffering in the community. Now the pendulum is swinging in the other direction."

However, Dr Bates said he was "absolutely convinced" from his own experience that anti- depressants work.

Prescriptions for anti-depressants grew by 50 per cent in the three years up to 2004, according to official figures. Over €5 million worth of Prozac was paid for by the HSE in 2006, and €5 million worth of Seroxat.

Aware, which assists people with depression, declined to comment but one of its board members, Dr Harry Barry, said he was "slightly wary" of the research which was "a study of studies" rather than original research.

Dr Barry, the author of a book on mental health, said doctors were often caught in the middle on the issue. "On the one hand, there is criticism of the use of drugs to treat the problem, while on the other, the required alternative services are not provided."

He said psychologists and cognitive therapists were in massive under-supply.

Dr Siobhán Barry of the Irish Psychiatric Association described the findings as stark and amazing.

She welcomed the large number of trials upon which the research was based, but said it was curious that the study was being published in a relatively unknown journal.

Dr Barry said it was not advisable for any person to suddenly stop taking medication on the basis of a single study. "However, we need to ask if there are other types of input that can overcome depression."

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.