Article

The unfulfilled promise of the antidepressant medications

16 May 2016
Description

Antidepressants are not as effective as we once believed.

Summary

  • Australia has one of the highest rates of antidepressant use in the world; it has more than doubled since 2000, despite evidence showing that the effectiveness of these medications is lower than previously thought.
  • An increasing placebo response rate is a key reason for falling effectiveness, with the gap between response to medications and placebo narrowing.
  • Psychotherapies are effective treatments, but recent evidence from high-quality studies suggests that their effectiveness is also modest.
  • Combined treatment with medication and psychotherapy provides greater effectiveness than either alone.
  • The number of patients receiving psychotherapy had been declining, although this trend is probably reversing with the Medicare Better Access to Mental Health Care initiative.
  • Antidepressant medications still have an important role in the treatment of moderate to severe depression; they should be provided as part of an overall treatment plan that includes psychotherapy and lifestyle strategies to improve diet and increase exercise.
  • When medications are prescribed, they should be used in a way that maximises their chance of effectiveness.
Publication Details
Identifiers: 
DOI: 
10.5694/mja16.00194
Published year only: 
2016
330
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