A study with the participation of millions of people has concluded that antidepressants do not improve the long-term quality of life of patients. Dr Vieta, head of the Clínic's Psychiatry Unit, explains that this conclusion is not reliable due to methodological errors.
A study carried out at the King Saud University in Saudi Arabia questions the effect that antidepressant medications can have on the general well-being of patients and their quality of life. The study concludes that the quality of life of patients treated with long-term antidepressants does not improve, and that future research should be aimed at investigating both the short-term effects and long term impacts of pharmacotherapy. Other, non-pharmacological approaches for patients should also be investigated as a viable alternative. The study lasted 11 years and included 17.5 million adults diagnosed with depression every 12 months. These were of north American origin, and were followed up every 2 years.
Dr Eduard Vieta, head of the Clínic's Psychiatry Unit, commented as follows on this finding, “In my opinion, the article has serious methodological flaws. Patients with depression who are medicated are compared with those who are not medicated, and the severity of cases is not controlled. Therefore, the comparison results cannot be attributed to the treatment, but to the patient characteristics, which is what determines whether he is treated or not.” He added, “It is like comparing COVID-19 patients treated with and without corticosteroids. Mortality is higher in patients treated with corticosteroids, but corticosteroids are given to the most seriously ill patients, precisely to save their lives.”
Other controversies about antidepressants
It was also observed that females represented two-thirds of the people included in the study. The WHO published a report in 2002 explaining that there is a gender bias in diagnoses of depression. The reason why this happens is still not fully understood, but there are theories about it, for example, gender bias. It is also believed that doctors diagnose the disorder more easily in women and prescribe antidepressant medication more easily than for men, despite them having similar symptoms.
Risk-benefit ratio
Previous research has shown that depressive disorder has a significant effect on the quality of life of many people and that significant improvements occurred in the first months after starting pharmacological treatment. Some experts suggest that psychotherapy or social support sessions should be prioritised before prescribing antidepressant treatment.
Dr Vieta agrees that antidepressant medication can be improved and should ideally be associated with psychotherapy; however, he added, "There is still a long way to go to get depression treatments to solve all the problems associated with this disease. However, current treatments save lives and help millions of people get their old lives, jobs and families back. This study does not provide valid or reliable information to help improve patient care.”
Information documented by: Dr Eduard Vieta, head of the Psychiatry Unit at the Barcelona Clínic Hospital
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