This is an important finding – and good news – for people considering antidepressants unsure if they’re going to work, for GPs getting a hard time for prescribing them and for researchers working to transform mental health.
For too long antidepressants have been shrouded in controversy: whether it’s the belief that these drugs are only prescribed to benefit big pharma companies, or TV shows linking them to homicide or simply a lack of faith that actually work. And this ‘pill-shaming’ culture in our society risks leaving people scared to take these drugs that have genuine benefits. They help people – and now we have strong data to show this.
That’s not to say that antidepressants are the entire answer – we know that psychological therapies are also a crucial part of recovery for many people. But it’s also true that sadly, they’re harder to access.
If nothing else, I hope the study will begin to help to break down the stigma around taking medication for mental health – and the important role it can have for many people.
So yes, it’s good news. But it also highlights just how far we have to go.
The scientists looked at 21 common antidepressants prescribed for major depressive disorder. And what struck me when reading the paper was just how old some of these drugs are. Amitriptyline, for example, was developed in the 60s. A chronic lack of funding into mental health is partly to blame, without investment into science we cannot develop new – and better – drugs.
It’s clear to see just how far mental health lags behind when you look at the stats: only £8 is spent on mental health research per person affected compared to £178 for cancer. We’re here to even up the playing field.
The study showed that certain drugs were more effective than others (although all were better than a placebo) – but it didn’t show why. We need scientists to unpick how these drugs work in the brain and understand the differences are between them. Only through this kind of research will we be able to create even better medication with less side-effects. It’s why we’re funding two projects looking at serotonin, an important chemical involved in antidepressants, to get to grips with the biology behind these drugs.
The reason these drugs don’t work for many people is also down to our lack of understanding about which antidepressants are best for which people. The study didn’t take into account the severity of symptoms, age, gender or other characteristics of people taking antidepressants – but these factors are vital.
The way we prescribe these drugs is pot-luck and we need better ways to match people to the best drug for them. In Dublin, Dr Claire Gillan’s project is using big data to create an algorithm that could predict which antidepressant is most appropriate. Perhaps with enough research, we can end the trial-and-error approach to treatment. We also need to see how effective these drugs are long-term, the trial revealed that most studies only follow people up for 8 weeks. With strategies that look at NHS data in real-time over a long period, like our adolescent data platform, we’ll be able to see the bigger picture.
The time is now to get these questions answered, so everyone facing depression can get the best treatment for them.
Last updated: 22 February 2018