Prozac… nothing more than a placebo?

[27 February 2008 - 11h39]
[mis à jour le 27 February 2008 à 17h38]

A British study has recently sown the seeds of controversy surrounding the effectiveness of antidepressants belonging to the selective serotonin reuptake inhibitor group (or SSRIs). This was the class of drugs heralded by Prozac (fluoxetine), the use of which in France has recently been extended to include children and adolescents! According to the conclusions of this study, these antidepressants appear to be – with few exceptions – about as effective as a placebo…

Dr Irving Kirsch’s team at the University of Hull reviewed 47 clinical trials relating to SSRIs. Some of these studies had been made public, but others had not … In fact, this meta-analysis takes into account all the scientific literature available on the subject. So, it is a serious study and one which has looked at not only Prozac (fluoxetine), but also Effexor (venlafaxine), Serzone (nefazodone) and Deroxat (paroxetine).

And the result is quite earth shattering. According to Dr Kirsch, this generation of antidepressants appears to be largely ineffective! “Patients feel better taking (them), (but) the same is true of those who were administered a placebo”. Furthermore, “the improvement is not very significant”, he points out. Only those patients suffering from “very severe” depression responded favourably to this type of treatment. But even then there is room for reservation: “the improvement in their condition appears to be associated more with a lesser reaction to the placebo than to a positive response to the antidepressants”.

As Dr Kirsch sees it, the conclusion is a simple and obvious one: “depressive patients can improve their condition without recourse to chemical treatment”. Of course, this is a highly sensitive subject and further studies must clearly be carried out to confirm or invalidate these conclusions. But as things stand, the study is bound to create a stir.

Be that as it may, no decision regarding changes in or the suspension of treatment with antidepressants must be taken without first consulting your doctor. Each decision must be taken on an individual basis according to the clinical case in question.

Source : PLoS Medicine, 25 February 2008

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