Now a large real-world study, published in the journal Psychological Medicine, has identified the groups of people who are least likely to find them helpful – which includes men and older people.
About three-quarters of people said that antidepressants had helped them “at least a little”.
Another risk factor linked with a lower chance of benefiting from the medicines was if people did not usually get a lift in mood from positive events.
The study did not investigate why these factors were linked with people’s odds of responding, and we should not assume the factors were directly causing the response, said Professor Cathryn Lewis, a geneticist at King’s College London (KCL). “We don’t know whether this is cause or effect,” she said.
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Alcohol can also make people feel more depressed, even though people often think it will improve their mood.
The relatively high number of people who said they were helped by the medicines was welcomed by Professor Peter Tyrer, a psychiatry researcher at Imperial College London, who was not involved in the research. “To get a 75 per cent positive response is a very important finding,” he said.
Antidepressants have come in for criticism in recent years, with independent analyses of drug company trial results suggesting they cause only small improvements in mood compared with people in comparison groups taking placebo tablets.
Placebo effect
But Professor Joanna Moncrieff, a psychiatrist at University College London who has previously criticised the growing use of antidepressants, said depression is particularly responsive to the “placebo effect” – when symptoms improve simply because people expect them to.
Professor Moncrieff said that this could also explain some of the “risk factors” that predicted non-response. “Some of the things they’ve found suggest that these are just markers of a more severe condition – like lower income,” she said.
A spokesperson for the Royal College of Psychiatrists said: “Most patients will benefit from the use of antidepressants, but as with all medications, some people have side effects or negative experiences, which is why their use should be carefully monitored and regularly reviewed.
“We would advise anyone thinking of stopping their antidepressant to talk to their doctor first, as these medications should not be stopped abruptly.”
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