Are antidepressants effective? A debate on their efficacy for the treatment of major depression in adults

ABSTRACT

Recently, the efficacy of antidepressants, a treatment used by 11% of US American adults, has been debated. Thousands of randomized controlled trials (RCTs) have been used to study antidepressants, with the majority demonstrating at least moderate superiority over placebo. In contrast, studies have found antidepressant effects to be unspecific and mainly resulting from placebo. The effects of antidepressants may also be overestimated due to selective publishing and selection of patients who have a high chance of response in RCTs. Studies have also shown the drugs do not reduce suicidal events when compared to placebo, and efficacy differences to placebo are often too small to prove clinical relevance. Here, we review the claims for and against antidepressant efficacy.

KEYWORDS:

• antidepressants
• randomized controlled trials
• efficacy
• placebo effect
• publication bias
• suicide
• switching antidepressants

Financial and competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.