RODALE NEWS, EMMAUS, PA—Twenty-seven million Americans—10 percent of women and 4 percent of men—are taking medication for depression. If you find that surprising, consider this: According to a study published this month in the Journal of the American Medical Association, most of them could get as much relief from taking a placebo. The study calls into question the widespread practice of prescribing antidepressant medication for people who are mildly or moderately depressed. Rather, it supports reserving the use of the drugs for severely depressed patients, those who feel hopeless and have trouble eating, sleeping, working, and performing tasks of daily living.
THE DETAILS: Researchers at the University of Pennsylvania analyzed the results of six drug trials, which included 718 patients taking medication for depression. The study authors found that the antidepressants studied, paroxetine (sold as Paxil and Serixat) and imipramine (sold under various names, including Antideprin, Deprinol, and Imipramil), were effective only for the most severely depressed patients. For patients with mild to moderate depression, and even some patients in the less-severe portion of the major depression category, medication for depression performed no better than placebo. That is, no better than a sham treatment such as a sugar pill.
With antidepressants in such widespread use, how is it that this phenomenon went unreported until now? In fact, most drug studies are done with severely depressed patients, the group that according to this data is most likely to show improvement with drug therapy. The six trials included in the JAMA article are among the very few that included less-depressed subjects, and thus, could yield a comparison between less and more depressed patients. By focusing on patients who had the most severe forms of depression and getting good results, most of the research done on antidepressants created the perception that all depressed people would benefit from their use.
Next page: What it means.