Antidepressant efficacy may be overblown-experts

Antidepressants, for the most part, do not provide meaningful benefit, two investigators in the UK argue in a report in the British Medical Journal this week, having reviewed published medical evidence on antidepressant efficacy.

Most people with depression are often initially prescribed an antidepressant by their doctor. Prescriptions for these medications have risen dramatically in the last decade.

"I do not think there is such a thing as a drug that will specifically relieve depression. I think so-called antidepressants are just drugs that do other things, such as sedating or stimulating people", Dr. Joanna Moncrieff, an author of the report, said.

In fact, she continued, "I am skeptical as to whether there is a biochemical syndrome of depression despite the portrayal by the drug companies and some psychiatric literature."

Moncrieff, a lecturer at the University College London and co-chair of the Critical Psychiatry Network, describes depression as a condition that "should be dealt with without drugs, because it's something people need to learn to deal with themselves." Dr. Irving Kirsch of the University of Plymouth is a co-author of the report.

In response, Dr. Darrel Regier, director of the Division of Research at the American Psychiatric Association told that Moncrieff and Kirsch have "written an article that selectively pulls out negative studies and conveniently ignores or mischaracterizes positive studies."

"The interesting issue," he said, "is that it is now medical malpractice not to treat serious major depression with medication. If in fact there were nonsignificant differences (between antidepressants and placebo), that would not be the standard of care."

"Theirs is a radical sociological approach that will do anything to deny the existence of a medical disorder that affects the brain, that somehow the brain is sacrosanct and you can't have illness of the brain," he concluded. "It really is a remarkably biased presentation."

SOURCE: British Medical Journal July 16, 2005.