FED: Depression drugs - emperor's new clothes?
By Judy Skatssoon, National Medical Writer
SYDNEY, Aug 24 AAP - Anti-depressant medications may be a case of the "emperor's newclothes", according to studies which show that drugs are only marginally better than asugar pill in banishing the blues.
Debate about the value of anti-depressants has spilled into the latest issue of theBritish Journal of Psychiatry (BJP), which highlights a recent US survey of the resultsof 19 anti-depressant drug trials.
The analysis found that placebos duplicated 80 per cent of the effects of anti-depressants.
"In this analogy psychiatry is the emperor, drug trials are the fraudsters," accordingto the BJP.
"The deception is being revealed by a growing body of critical opinion proposing that... anti-depressants either don't work at all or have an effect that is so small as tobe clinically unimportant."
Professor Ian Hickie, head of Australia's beyondblue (beyondblue) depression initiative,said it was well known that drugs were just as effective in treating mild to moderatedepression as non-drug treatments, such as professional and ongoing counselling.
However, he said it was wrong to suggest the drugs didn't work.
"The worldwide evidence is that professionally delivered non-drug treatment is as effectiveas drug treatment for mild to moderate depression," he told AAP.
"The drugs have very little additional benefit if you do all the other stuff."
Prof Hickie said there was an increasing bias towards prescribing drugs rather thanrecommending non-drug treatments, largely because the government believed it was cheapestto provide subsidised drugs.
Some 800,000 Australian adults suffer from depression each year and doctors - 80 percent of them GPs - write 6 million scripts for anti-depressant drugs.
Anti-depressants are also one of the fastest growing areas of the government's PharmaceuticalBenefits Scheme (PBS).
"What we could end up with is a system out of balance," Prof Hickie said.
Writing in the Journal of Psychiatry, Gordon Parker, head of the NSW Black Dog depressioninstitute, said the problem lay not with the drugs but with the way studies into theireffectiveness were carried out.
He said depression was currently classified as a single disorder rather than a setof separate disorders which responded differently to various treatments.
There was also a problem with the sort of people being recruited to trails and thepotential for bias on the part of researchers, Prof Parker said.
"Current operational strategies for trials are producing specious and irrelevant information,compromising rationality and reality," he writes.
"They need to get real."
AAP jjs/sjb/br
KEYWORD: DEPRESSION
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