Placebo as Effective as Drugs for Mild Depression
A recent meta-analysis of six studies suggests that a placebo may be as effective as an antidepressant drug in treating mild to moderate depression. The study reported in the Journal of the American Medical Association (JAMA) found that placebos performed as well as antidepressants for patients with mild to moderate depression. However, for those with severe depression or long-lasting (chronic) moderate depression, drug therapy was still more effective.
“Antidepressant Drug Effects and Depression Severity” was autored by researcher Jay C. Fournier, MA of the University of Pennsylvania and his associates.
The study highlights the fact any antidepressant may be very effective for some patients, and have little effect – or negative side effects – for others. For reasons that are not clearly understood, some patients respond well to antidepressants while they fail to help others. The most serious side effect is increased risk of suicidal thoughts and even suicide in certain patients. Often, a patient who fails to respond on one drug will improve on another – but this is not true for every patient.
Most antidepressant drugs are SSRIs, or Selective Serotonin Reuptake Inhibitors. Serotonin is a feel-good neurotransmitter naturally released in the brain. SSRIs work by preventing neurons from recapturing the natural serotonin in the brain, gradually increasing the amount available.
The meta-analysis examined six studies involving the SSRI Paxil and imipramine, comparing them to a placebo. A meta-analysis combines data from several studies, analyzing it in a statistically valid way, to yield new findings with larger groups of subjects without repeating research.
In the JAMA meta-analysis, some patients with mild to moderate depression responded to the medications, while in others the depression became more severe. Some patients given the placebo improved on their own. The net result was that while antidepressants helped some of the patients some of the time, it performed no better than the placebo for mild to moderate depression.
Other research has shown that up to 50% of patients with mild depression improve in time, even if left untreated. Patients whose depression is related to recent losses or life events respond especially well to talk therapy and exercise.
About 7 percent of Americans suffer from depression at any given time. More than 67 million prescriptions were written for the top three antidepressants in 2009. A recent study of 16,000 people found that 51 percent of those with major depression received no treatment. Latinos and African Americans were less likely to receive treatment, even when their depression was severe.
By Joni Holderman, [email protected], contributing reporter for Mental Health News.