SSRIs Effective for the Treatment of Depression

Selective serotonin reuptake inhibitors (SSRIs) are an effective treatment for depression, according to the results of a recent study.

“It has been suggested that the superiority of antidepressants over placebo in controlled trials is merely a consequence of side effects enhancing the expectation of improvement by making the patient realize that he/she is not on placebo,’ the researchers wrote.
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They conducted a patient-level post hoc-analysis of 15 placebo-controlled trials of citalopram or paroxetine in adults with major depression that used the Hamilton Depression Rating Scale (HDRS).

They found that compared with individuals who received placebo, those who received SSRIs and did not experience early adverse events had a significantly greater reduction in depression symptoms. Further, in participants who received SSRIs with early adverse events, the severity of the adverse events did not predict response.

Sensitivity analyses, including those that removed all patients with adverse events, all supported the conclusions of the primary analyses.

“The finding that both paroxetine and citalopram are clearly superior to placebo also when not producing adverse events, as well as the lack of association between adverse event severity and response, argue against the theory that antidepressants outperform placebo solely or largely because of their side effects.

—Michael Potts

Reference:

Hieronymus F, Lisinski A, Nilsson S, Eriksson E. Efficacy of selective serotonin reuptake inhibitors in the absence of side effects: a mega-analysis of citalopram and paroxetine in adult depression [published online July 25, 2018]. doi: 10.1038/mp.2017.147.