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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Are antidepressants just placebos?

A meta-analysis of trials of antidepressants has been published in PLoS Medicine. The study concluded that differences between these drugs and the placebo effect are small. This study has been reported in the general media.

The study included data requested under the Freedom of Information Act from the Food and Drugs Administration for six antidepressant medications. Forty seven trial papers were examined including some studies that remain unpublished, of these 35 were included in the full analysis.

The analysis found that there was no clinically significant difference between the antidepressants and placebo except for the most severely depressed patients (those with a baseline Hamilton Scale of greater than 28). A recent NPCi blog has also reported on the apparent publication bias in studies of antidepressants.

Action: Media reporting of this study is likely to generate queries from patients and may affect confidence in treatment. Clinicians should continue to follow existing NICE guidelines including making use of non-drug interventions and watchful waiting in milder cases with drug treatment reserved for more severe cases.

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