The 21 most commonly used antidepressants in the world are more effective than placebo for the short-term treatment of major depression in adults, shows a large international study. The effectiveness of treatment ranges from mild to moderate, depending on the type of medication.
The authors of this meta-analysis believe that their results settle once and for all the question of the effectiveness of antidepressants.
The data from 522 studies involving 116,477 people were employed in this work published in the journal The Lancet(in English) , which still show large differences in the effectiveness of each drug.
Currently, pharmacological and non-pharmacological treatments are available, but due to lack of resources, antidepressants are used more frequently than psychological interventions. However, their effectiveness is not unanimous.
Did you know?
- As many as 350 million people are currently suffering from depression.
- In Canada, about 11% of men and 16% of women experience major depression in their lifetime.
- The costs associated with mental illnesses reach $ 50 billion annually in Canada.
In their study, researchers analyzed randomized controlled trials comparing drugs against depression with each other or with placebo. They then contacted pharmaceutical companies, study writers and regulators to complete their work. They also compiled data from unpublished studies.
In addition, the study found that treatments were more effective in a proportion of one-third more effective than placebo more than twice as effective.
The question of whether antidepressants really work was still a problem. Some studies have shown that there is no difference between placebo and the drug. But this meta-analysis of more than 500 studies clearly shows that these drugs work.
Matthias Egger, Director of the Institute of Social and Preventive Medicine at the University of Bern, Switzerland
The most effective antidepressants:
- escitalopram (Lexapro, Cipralex, Sipralexa and Seroplex)
- agomelatine (Valdoxan, Melitor and Thymanax)
- amitriptyline (Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl, and Redomex)
- mirtazapine (Norset and Remeron)
- paroxetine (Paxil, Deroxat and Seroxat)
- venlafaxine (Effexor)
- Vortioxetine (drug candidate)
The least effective antidepressants:
- Fluoxetine (Prozac and Sarafem)
- fluvoxamine (Floxyfral)
- Reboxetine (Edronax)
- trazodone (Desyrel, Trittico, Thombran, and Trialodine)
The majority of the most effective antidepressants are now off patent and on sale in generic form.
Tolerability also assessed
Antidepressants also differed in terms of tolerability related to the effects of drugs on the body. Agomelatine, citalopram, escitalopram, fluoxetine, sertraline and vortioxetine were the most tolerable, and amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone and venlafaxine the least tolerable.
The authors recall that their data cover eight weeks of treatment and therefore do not necessarily apply to the long-term use of antidepressants.
“Our study brings together the best information available to date to guide physicians and patients in their therapeutic decisions,” says psychiatrist Andrea Cipriani of Oxford University, one of the main authors of this work.
The results of this study contrast with a similar analysis in children and adolescents, which showed that fluoxetine was the only antidepressant that could reduce depressive symptoms.
Dr Nancy Miller has over 20 years experience as a educator and health practitioner. She has a B.S. from Lake Head University In Thunder Bay, and a Ph.D. in biology from the University of Guelph . Dr. Miller has worked as a special medical consultant for a major insurance provider before becoming a freelance health author and public speaker. There are several ways to contact Dr. Miller here.