A Depressing Controversy About Anti-Depressants
by Emilia Dellemonico


Newspapers across the nation have once again been reporting on the question of just how happy can your Prozac make you? Researchers looking into the clinical trials of many typical antidepressants currently on the market have come to a startling conclusion; these so called “happy pills” are not much better than the common sugar pill used as placebos in test trials. Unfortunately, many in the media seem to be reporting only this side of the story, downplaying any use the of pill, even if it is only for a certain level of depression.

The current study catching most people’s attentions is a meta-analysis (combining information from many studies to find an overall effect) based on data from all antidepressant clinical trials reported to the FDA. The results indicated that Prozac and other SSRIs, the types of antidepressants most often prescribed today, including Paxil, Serxat, and Efexor, showed no more improvement than a placebo except in the most severely depressed patients. This study brought new attention to the controversy which started back in 1999 with another highly criticized meta-analysis that did not have access to FDA data at the time, and was more often than not dismissed as inconclusive.

The study has been published on the Public Library of Science (PLoS) website, and the results concluded that “the overall effect of new-generation antidepressant medications is below recommended criteria for clinical significance,” and furthermore found that while it indeed showed to be more effective in the severe cases, that this difference seemed to be “due to a decrease in the response to placebo rather than an increase in the response to medication.”

This evidence seems to indicate that drug companies have been dramatically overstating the effectiveness of their medications, and have been purposely publishing only the trials that showed the most positive results of their products, and not making public the less positive, more abundant, results. This has made millions of people question the drugs they’ve been using as a solution to clinical depression, as well as the intent and trustworthiness of the pharmaceutical industry.

Drug companies responsible for these antidepressants continue to refute the accusations that their products do not work as expected. Eli Lilly, which manufactures Prozac, has stated “extensive scientific and medical experience has demonstrated it is an effective antidepressant.” Other companies remark that the studies do not look at all SSRIs and can still not account for all trials done on the drugs.

Other critics of the studies draw attention to the fact that since the study is a meta-analysis of clinical data, the conclusions it comes to would be susceptible to any methodological or statistical weaknesses that are inherent whenever you combine multiple studies. This leaves the possibility open that this study may not have as much weight as many are attributing to it.

Unfortunately, much of the controversy in this story is being left out by the majority of newspapers covering it. While the results from the meta-analysis suggest the effect of the drugs is not nearly as potent as promised by its manufacturers, David Nutt, a psycho-pharmacologist at Bristol University in the UK, pointed out, “the true drug effect is that of the drug added to that of placebo which is not the same as no treatment.” In other words, taking the drug is still better than just taking a sugar pill, a distinction often not made clear to readers.

The controversy also does not explain how similar antidepressants are to placebos, but rather how effective the antidepressants are, and how beneficial it would be for the majority of people using it. Psychologists writing for the Scientific Review of Mental Health Practice call attention to this fact: “Even critics of antidepressants acknowledge that a genuine difference exists between antidepressants and placebos, with the debate focusing on how large this difference is and the mechanisms responsible for it.”

So before you throw out your bottles of Prozac and commit yourself to a life of hopelessness and lethargy, keep in mind that no matter how effective the drug really is, it has probably made you feel like its working. Not only that, the results in studies like this are not final, and before you decide to accept the word of your local news report as truth, find out more about it for yourself.