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A study by the Food and Drugs Administration in the United States announces that antidepressants are really more effective than a placebo in only 15% of cases. A new questioning about these drugs?
Do antidepressants have a conclusive effect on depression? Are they effective on all patients? The subject is regularly debated, without it having to encourage the people concerned to abandon their treatment without the advice of their doctor. But a new study published in the British Medical Journal could, once again, sow doubt. A team from the Food and Drugs Administration (USA) shows that only 15% of patients with a major depression disorder really benefit from antidepressants, compared to placebo. In other words, in 85% of cases, the antidepressant would not do better than a placebo.
In the figures, hardly more effective drugs
To arrive at these figures, the team analyzed data from 232 randomised, double-blind, placebo-controlled trials of a monotherapy drug for major depressive disorder, between 1979 and 2016, including 73,388 adults and children. For the study, the severity of depression was assessed using the Hamilton scale, and the effect of antidepressants or placebos assessed. Results ? The drug offers more efficacy and results on average on the patients evaluated… But the difference with the efficacy of taking the placebo in the scores obtained turns out to be rather small. On this scale, the improvement with the antidepressant was 12 points, compared to 10 points with the placebo.
With an unknown factor still very present: if the study shows the effectiveness of antidepressants in certain cases, we do not yet know how to predict in advance who will respond well to drug treatment and who will not.
In reality, a result assessed on a case-by-case basis
The slight difference raised by this study between drug and placebo in the field of depression can be questioned, but remains in the field of research. For Guillaume Fond, psychiatrist interviewed by the magazine Medscape on the subjectthere really isn’t an indisputable answer when it comes to antidepressants: “Lheterogeneity of depression is such that some patients respond to nothing, and others to everything, including placebo” he admits. As for the very effectiveness of the drugs, there again it is a story of the subject: “We’re going to prescribe an antidepressant with a certain mode of action. If we get it right, there will be a good answer. But there can also be minimal response or no response with significant side effects”, he continues.
It should also be remembered that the research that is in progress should be taken with caution, without rejecting a treatment that seems to work for you. As psychiatrists regularly remind us, treatment should never be interrupted without having spoken to a health professional beforehand.