Only 15% of patients have significant improvement with antidepressants

Depression: The study showed that antidepressants only worked in 15% of patients on a large scale. understand

Depression, its causes and the effectiveness of treatments available today are targets of many scientific studies that seek to better understand the role of disease in the human body and ways to combat it.

Interest in the topic is not for nothing, according to the latest Vigitel survey, conducted by the Ministry of Health, about 11% of the Brazilian population suffers from the condition.

However, a recent review of research indicated that a lack of serotonin in the brain – a condition attributed to the development of the problem – could not be confirmed as a cause of depression, leading many patients to question whether antidepressants actually work for the diagnosis. . .

Now, a new study published in the British Medical Journal (BMJ) has confirmed that the drugs work, but not for everyone significantly.

Conducted by researchers from the Food and Drug Administration (FDA), the US regulatory agency; from Johns Hopkins University; From the Cleveland Clinic and Harvard University, the work analyzed 232 studies with data from 73,338 participants, conducted between 1979 and 2016. The result was that only 15% had significant long-term drug benefits observed.

To assess this response to drugs, the studies used an indicator called the Hamilton Scale. It is obtained by a 17-item assessment that gives the patient a score from 0 to 56 points, the higher the depression, the more severe the depression.

After analysis, the researchers concluded that overall antidepressant treatment was affected, on average, by just 1.8 points on the scale compared to placebo, a proven but small effect.

That’s because while the drug treatment led to a drop of about 9.8 points on the scale, those who received the placebo scored 8 units lower – so only 1.8 points were awarded to the drugs.

For the researchers, the “widespread” effect of the drug, which can be seen in a drop of 16 points, was limited in the studies.

Only 24.5% of participants who took the medication reported a “widespread” drop, and 9.6% in the placebo group.

Only 15% of patients have significant improvement with antidepressants

Comparing the two cases, the figures indicate that only 15% of patients actually achieved the reduction considered significant with antidepressants.

“[The results]indicate that about 15% of participants had a significant antidepressant effect in addition to the placebo effect in clinical trials (…) More research is needed to identify a subset of patients who are likely to need antidepressants. (…) Given the modest absolute potential for significant benefit over placebo, and when consistent with patient availability and preferences, it may be best to start with low-risk treatments for mild to moderate severe depression.” through study.

The conclusion is not surprising, because the drugs work by raising neurotransmitters such as serotonin in the brain. However, a comprehensive review by British scientists published in Molecular Psychiatry this year stated that “main areas of serotonin research do not provide consistent evidence for an association between serotonin and depression, and there is no support for the hypothesis that depression is caused by decreased serotonin activity or concentrations.” .

The publication of the work sparked a debate about the true effectiveness of antidepressants. However, the researchers explained that depression is already known to have a number of causes, and that it cannot be attributed solely to a lack of serotonin.

In an article published in The Conversation, University of Edinburgh Professor of Biological Psychiatry, Andrew M. Macintosh, and Catherine Lewis, Professor of Epidemiology and Genetic Statistics at King’s College London, both in the United Kingdom, outline what is known about diagnosis.

“The roots of depression are diverse and people can have very different causes for their symptoms. Psychological trauma is a well-established risk factor. Inflammation is increasingly being recognized as a possible cause in many research studies. Many genetic factors have also been identified, each with very little effect. It is likely that there are Thousands of small genetic influences with each person having a nearly unique combination that can increase the risk of developing depression.

They also note that the evidence separating depression from insufficient serotonin concentrations does not rule out benefits observed in many studies with antidepressants.

“Randomized controlled trials of thousands of depressed people have demonstrated beyond reasonable doubt that antidepressant medications are effective in treating depression (…). We are continually beginning to understand more about the causes of depression and identify the subtypes, or “depression,” that have mechanisms and treatments More specifically Our understanding of depression and its treatment has been advancing for more than a century and showing no signs of slowing down. It is difficult to pinpoint new causes and treatments for depression, but they are essential if we are to address one of the most common causes of disability worldwide.