Antidepressants generally no better than placebo, but that doesn’t mean they’re easy to stop

I don’t know what health news stories were circulating in other parts of the globe, but here in the UK we have not been able to move for the ‘revelation’ that, for the majority of people who take them, popular antidepressants work no better than placebo.

This story was spawned from the results of a newly published study which assessed the results of trials of four antidepressants including those of the SSRI (selective serotonin reuptake inhibitor) type, such as paroxetine (Seroxat) and fluoxetine (Prozac) [1]. What was interesting about this study is that it mixed up the results of not just published studies, but unpublished research too.

The reason that this is relevant is that the pharmaceutical industry is well known to engage in a spot of ‘publication bias’ when it suits it. This practice, essentially of publishing favourable results while ‘burying’ less useful data, can give doctors and their patients a very skewed impression of the effectiveness of a treatment. Putting published and unpublished (well, at least the stuff we can get our hands on�) together will inevitably give a more accurate guide to whether a treatment works or not.

In this case, the mix of published and unpublished data showed that antidepressants appear not to work any better than placebo for all but the most severely depressed. Seeing as the great majority of people who take antidepressants do not fall into the ‘severely depressed’ category, the results of this study suggest that, in the main, they’d be just as well off with a sugar pill as they are with their expensive and potentially toxic antidepressant.

While listening to the radio yesterday, I heard more than one commentator express concern about these results and what they mean, but at the same time warning people not to come off their meds. Go and ‘talk it through with your GP’ was the message. One might imagine that there’s going to be a fair few uncomfortable consultations going on over the next week or two as a result of these study results and the advice that antidepressant takers should chat it over with their doctor.

I suspect a fair few people are going to feel aggrieved at having taken antidepressants that have been licensed despite the fact that the data does not support this. But that’s only half the problem: if someone decides that they want to stop these drugs they may find they’re in for a hard time. The reality is that abrupt cessation (and even gradual weaning) from antidepressant drugs can give rise to quite debilitating ‘withdrawal’ symptoms including dizziness, anxiety, sleep disruption and mood swings.

So, not only may people have unwittingly been taking a drug which, generally speaking, is no better than placebo, but they may find getting off this drug quite difficult.

I am no expert on getting off antidepressants, but I can say from experience that individuals wanting to take this course generally need to wean off g-r-a-d-u-a-l-l-y over a few weeks or months and maybe even a year or so. This is generally best done in conjunction with a supportive doctor.

While this most recent study made big headlines yesterday, the fact is there’s nothing ‘new’ in this story really. As recently as January, a study was published that showed quite clearly that many ‘negative’ antidepressant studies are not published.
Some are calling for the publication of studies on antidepressants to be mandatory. I support this, but suggest it should be extended to all drugs, period.

And here’s another thing I’d like to see: drug companies acting responsibly by sponsoring educational programmes for doctors, the purpose of which is not to get them writing more prescriptions for antidepressants, but less. And how about them including in these programmes information on how best doctors can support their patients wishing to get off these drugs, particularly those suffering from withdrawal.

I have a feeling this isn’t going to happen anytime soon, as such events would be tacit admission of a problem that has been caused, at least in part, by the failure of drugs companies to freely and willingly disclose all their data. I have a feeling that drug companies may be forced to dig deep anyway: it’s not too difficult to imagine that some individuals will feel that some compensation is due, even if they have to go through the courts to get it.


Kirsch I, et al. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the food and drug administration. PLoS medicine. 2008:5(2):e45

6 Responses to Antidepressants generally no better than placebo, but that doesn’t mean they’re easy to stop

  1. Hilda 29 February 2008 at 11:22 am #

    There are many conditions which can be helped nutritionally including depression. Most doctors know little about these ideas. Would it not be a good idea to try the natural way first for most conditions, then if it does not help, try something more medical? However nautural treatments cannot be patented. THe idea of a simple chemical (which drugs are) dramatically improving health for many illnesses seems ludicrous (although we do have some) such as antibiotics and thyroxine ). HIlda

  2. Tiggy 29 February 2008 at 11:02 pm #

    They don’t even know if they’re targeting the right neurotransmitter with anti-depressants. I think some people need an increase of dopamine, whereas most anti-depressants increase serotonin or norepinephrine or both. Agnus Castus is good for increasing dopamine – it just gives you a relaxed, happy feeling, though a minority of people find it gives them headaches.

    Inositol is very helpful in getting off anti-depressants, or you can go onto Prozac which is easier to come off. You have to be careful though because everything can be going fine and then suddenly you crash and get something akin to flu for a week. You have to do it much more slowly than the pharmaceutical companies suggest. Also Inositol can make you sleepy so start with small doses.


  3. Julia 2 March 2008 at 9:32 am #

    It took me six months to withdraw from a period of nine years on anti-depressants (after repeatedly trying to come off them in the manner my GP suggested which caused me to feel dreadful and persuaded me that I must still need the tablets). Following advice from an organisation that also helps people to withdraw from tranquillisers, I asked my GP to prescribe liquid Prozac which can be diluted very, very gradually so that withdrawal is much easier.

  4. Steve Hayes 2 March 2008 at 2:29 pm #

    As the director of Novus Medical Detox, I often see patients who are on alcohol or opioids, central nervous system depressants, also taking antidepressants. When they detox they find they don’t need the antidepressants.

    This is good news because a Swedish study showed that 52% of the 2006 suicides by women on antidepressants. Since antidepressants work no better than placebos and are less effective than exercise in dealing with depression.

    There is a prescription drug epidemic and these are leaders in the list of terribe abuses.

    Steve Hayes

  5. Hilda 3 March 2008 at 9:16 pm #

    Inositol might be OK but it is better to look at the whole diet. Just taking a few supplements would not be enough. For example lots of people take fish oil but how can a capsule compete with all the hyd fat and veg oil in the diet?

  6. John 18 October 2008 at 4:05 pm #

    Im 25 years of age and iv been taking antidepressants since i was 17.I have had to change a few times due to them not working and nasty side effects. However Iv been using Amitriptyline for about 4 years now(200mg a day). I would not say they make me happy but they do control my emotions on a great scale and stops me from breaking down and reduces my self-harm.(also helps me sleep). Iv used alot of drugs on and off the street when i was younger and i know whats a hit is and what isnt. Saying Antidepressants is just like a placebo is not write and it would be interesting to know how many doctors that are on antidepressants them-selfs were asked.

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