The drugs don't work?

A new study has concluded that anti-depression drugs are largely useless. So what about all those clinical trials?

Last Updated: 31 Aug 2010

Researchers at the University of Hull have reviewed data on 47 clinical trials of anti-depressants like Prozac and Seroxat (including previously unpublished data obtained under the Freedom of Information Act) and concluded that they are no more effective than a placebo for most patients. The only exception was for severely depressed people, and even then there was very little positive effect – it just worked marginally better than the placebo.

The academics reckon their study is unique because it is based on such complete data sets. Lead professor Irving Kirsch said it ‘raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported’ and argued for the prescription of these drugs to be further restricted. He wants more focus on counselling – but then that’s a lot more expensive than pills…

No doubt some cynics will cast aspersions on the University of Hull’s credentials – and to be fair, they wouldn’t be the first. You may remember an episode of Blackadder Goes Forth when Blackadder asks Nurse Mary if her boyfriend ‘had been one of the great universities, Oxford, Cambridge, or Hull’, and supposedly identifies her as a spy because she failed to spot that ‘that only two of those are great Universities’ (to which General Melchett replies: ‘That's right! Oxford's a complete dump!’). There’s a similarly sarcastic reference in Alan Bennett’s History Boys – but then Philip Larkin was a librarian there, so he obviously approved.

Still, it’s hard not to feel some sympathy for the drug companies (albeit not generally the most sympathetic of organisations). After all, before hitting the shelves these drugs have undergone years of rigorous clinical trials, where the makers have to produce detailed evidence that they do actually work. Eli Lily, maker of Prozac, said the drug’s effectiveness had been proved by ‘extensive scientific and medical experience’, while Seroxat maker GSK claimed the study had only looked at a ‘small subset of the total data available’.

Of course, given the amount of money they make from these drugs, they’re not exactly impartial witnesses. Over 30m people were prescribed anti-depressants in 2006 – undermining this could cost the drug companies tens of billions of dollars in revenue and savage their share price. So arguably, they would say that.

These drugs almost certainly do get over-prescribed – there was a time when Prozac in particular was being handed out like Smarties. And in these cases, they probably don’t have much of an impact. But equally, there are plenty of recorded cases of patients who have benefited from the drugs. So frankly, we’re not entirely sure who to believe...

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