Examining the Effectiveness of Antidepressants

Antidepressants are often demonized amongst the public, with many believing that they do not work. Studies over the years have yielded different results, but the general consensus is that they work marginally better than placebo.

A new review from Cochrane provides further evidence to this effect. Authors analyzed the effectiveness of antidepressants in treating generalized anxiety disorder (GAD). The review used data from 37 randomized controlled trials involving 12,226 participants, assessing the impact of various antidepressants on GAD symptoms.

Antidepressants demonstrated a statistically significant advantage over placebo in reducing anxiety symptoms. The review compared multiple types of antidepressants, including selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, and other classes, in terms of both efficacy and tolerability. Results suggest that these medications are more effective than a placebo at relieving symptoms of GAD, with a reduction in anxiety levels observed across most treatment groups.

However, the review also highlights important considerations regarding the acceptability of antidepressants for treating GAD. Although antidepressants were more effective than placebo, a greater number of participants in the antidepressant groups discontinued treatment because of adverse effects. Common side effects associated with these medications include nausea, fatigue, and sexual dysfunction.

One limitation noted by the authors of the review is the lack of clarity and transparency in some of the included studies. The review suggests that future research should prioritise more rigorous methodologies and include participants with co-occurring medical conditions, which were often excluded in earlier studies.

Commenting on the study, Gemma Lewis, a senior research associate at University College London, highlighted another limitation. “Most studies only followed people for up to 12 weeks. In reality, we know that many people use antidepressants for much longer than this, often for several years. In the future, we need trials that follow people for longer periods,” she explained. “GAD is the most common mental health problem, and it can be very debilitating. However, in research, and also perhaps clinically, it is often neglected, particularly when compared to depression.”

Christiaan Vinkers from the Department of Psychiatry and Anatomy and Neurosciences, Amsterdam UMC, added: “Antidepressants continue to face disproportionate skepticism, whether it is for GAD or depression. If these results were for heart disease or diabetes treatments, they’d be celebrated. Instead, antidepressants are often unfairly stigmatized, fueling misinformation which can deter people from seeking treatment that can have added value. Antidepressants aren’t a cure-all, but they are an essential, effective tool.”

A number of big pharma companies have approved antidepressants and the market for mental health disorders continues to grow. Last year, an S&S Insider report indicated that the anxiety disorders and depression treatment market could be valued at $16.65 billion by 2032. However, the Cochrane Review demonstrates a clear need for new treatments with reduced side effects.