Almost 35 years ago American drug regulators approved Prozac, the first in a series of blockbuster antidepressants known as selective serotonin re-uptake inhibitors (ssris). Prozac and its cousins were lauded by patients and doctors as miracle drugs. They lifted low moods quickly and seemed to have no drawbacks. Divorce, bereavement, problems at work—a daily pill was there to help with that, and anything else which made you sad. Many people have stayed on these drugs for life. In Western countries today between one person in seven and one in ten takes antidepressants.
The shine of ssris has worn off. A growing number of studies show that they are less effective than thought. Drug companies often publish the results of clinical trials selectively, withholding those in which the drugs turn out not to work well. When the results of all trials submitted to America’s medicines regulator between 1979 and 2016 were scrutinised by independent scientists, it turned out that antidepressants had a substantial benefit beyond a placebo effect in only 15% of patients.
Clinical guidelines have been revised accordingly in recent years. No longer are drugs the recommended first line of treatment for less severe cases of depression. For these, self-help guidance, behavioural therapy and recommendations for things like exercise and sleep are preferable. For work burnout, a sick note for time off may suffice. The drugs are to be reserved only for more severe depression, where they can be truly life-saving.
Lots of people who do not need antidepressants are already on them, refilling prescriptions written years or even decades ago. They should be helped to get off the drugs https://t.co/Rbz8cN9ogl
— The Economist (@TheEconomist) October 20, 2022