Current recommendations for prescribing antidepressants should be reconsidered, argue mental health experts in this week's BMJ.
Most people with depression are initially treated with antidepressants, and prescribing has risen by 253% in 10 years. Yet recent studies show that SSRIs have no clinically meaningful advantage over placebo, write Joanna Moncrieff and Irving Kirsch.
Furthermore, claims that antidepressants are more effective in more severe conditions is not strong, while data on long term outcome of depression and suicide do not provide convincing evidence of benefit.
All this implies the need for a thorough re-evaluation of current approaches to depression and further development of alternatives to drug treatment, say the authors.
Since antidepressants have become society's main response to distress, expectations raised by decades of their use will also need to be addressed, they conclude.
Joanna Moncrieff, Senior Lecturer in Social and Community Psychiatry, Department of mental health Sciences, University College London, UK
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Irving Kirsch, Professor of Psychology, School of Applied Psychosocial Studies, University of Plymouth, UK
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