Antidepressants Do Not Improve Quality of Life

13
2010

A new study found that taking antidepressants did not improve quality of life. The study compared millions of Americans (all with a depressive disorder diagnosis) who either used or did not use antidepressant medications.

“The real-world effect of using antidepressant medications does not continue to improve patients’ HRQoL [health-related quality of life] over time,” the researchers write.

The data came from the US National Medical Expenditures Panel Survey (MEPS). The researchers write that 17.47 million people were diagnosed with depression, and a little over half of them received an antidepressant (57.6%). White women were more likely to be diagnosed with depression and prescribed an antidepressant.

The research was led by Omar A. Almohammed in the department of clinical pharmacy at King Saud University, Saudi Arabia. It was published in the peer-reviewed open-access journal PLOS One.

Image of a young girl looking at a handful of antidepressants.HRQoL was measured using a survey called the SF-12, which included two components, the physical summary (PCS) and mental summary (MCS). The researchers found no difference in the MCS or PCS between those who took antidepressants and those who did not.

They write that the analysis “shows no significant difference from baseline to follow-up between the two cohorts of those who received antidepressant medications compared to those who did not (PCS: – 0.35 vs. – 0.34, p-value 0.9595; MCS: 1.28 vs. 1.13, p-value 0.5284).”

Interestingly, in media coverage of the study, psychiatrists who were not connected to the research claimed that the researchers did not control for baseline depression severity, which is simply false. According to the authors, it is true that “the MEPS does not provide information on the severity of depression.”

However, Almohammed et al. write that they used a “difference in difference analysis” to “compare each subject’s follow-up levels to his/her individual baseline levels for the PCS and MCS and investigate the overall change for the group, which should minimize the impact of this factor on the overall analysis.”

In clinical trials, antidepressants often don’t beat a placebo. According to a study in the top medical journal New England Journal of Medicine, in 49% of all antidepressant trials, the placebo was just as good as the drug. Even in positive studies, antidepressants are consistently less than 3 points better than placebo on the Hamilton Depression Scale (a 53-point measure), which researchers have called a clinically undetectable difference.

In the current study, Almohammed et al. cite these findings: “The difference between the placebo and treatment groups was very minimal in the meta-analyses that included data from published studies, and when data from unpublished studies were combined with data from published studies the difference became statistically insignificant, or even clinically undetectable.”

According to Almohammed et al., their results indicate that clinicians should consider psychotherapy and other less-intrusive measures as first-line interventions before or alongside antidepressant prescription.

They write, “It is necessary to reconsider the importance of non-pharmacological therapy, including psychotherapy, and its placement in the clinical practice guideline. Physicians, mainly primary care providers who are caring for most of these patients, may need to reconsider referring patients with depression to receive some kind of non-pharmacological therapy, such as behavioral therapy, psychotherapy, social support sessions, or education before or when initiating these patients on antidepressant medications.”

 

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Almohammed, O. A., Alsalem, A. A., Almangour, A. A., Alotaibi, L. H., Al Yami, M. S., & Lai, L. (2022). Antidepressants and health-related quality of life (HRQoL) for patients with depression: Analysis of the medical expenditure panel survey from the United States. PLOS One. Published online on April 20, 2022. https://doi.org/10.1371/journal.pone.0265928 (Link)

13 COMMENTS

  1. “clinicians should consider psychotherapy and other less-intrusive measures as first-line interventions before … antidepressant prescription.”

    Unfortunately many psychologists bought into big Pharma’s propaganda on the “antidepressants,” so their first line of treatment recommendations are to immediately put someone on an antidepressant and/or antipsychotic. Rather than actually doing some form of “psychotherapy” or other “less-intrusive measures as first-line interventions.”

    But I will confess, in my case, my psychologist was functioning as the child abuse covering up “partner” of my former religion. As opposed to actually functioning as a “therapist” for me, the person paying her.

    I do most definitely agree, however, that “Antidepressants Do Not Improve Quality of Life,” and the medical and psychological industries do need to garner insight into the common adverse and withdrawal symptoms of them.

  2. “White women were more likely to be diagnosed with depression and prescribed an antidepressant.”

    This is due to pervasive sexism and ultimately the outdated and sexist habit of ascrbing god to be male, by extension with a phallus.

    Futhermore, many likenesses of god represent a white male as god, so god has become a white male overlord in society. White women in short internalize and experience all the fallout from society’s white male god.

  3. 1) The group that did not take antidepressants long term had demographics associated with worse health outcomes. Some example’s being they were poorer, less likely to be married, less likely to have health insurance and more likely to be minorities.
    2) The group that did not take antidepressants had worse starting baseline scores.

    It appears psychiatrists don’t even bother reading studies and instead just copy and paste “people off drugs weren’t as sick.” That or they do read them and are lying for self gain.
    In studies on every other medical modality people who comply have better outcomes —not counting any medicinal effects— compared to people who do not. That psych thinks parading out that poor people who don’t follow health advice are inheritantly always healthier and better off than richer people who follow health advice is a confession. Psych drugs are so damaging that they reverse the health benefits of wealth.

    Some aspects of this study bias the results in favor of antidepressants. This study excludes all the people killed from and institutionalized from the drugs. Imagine someone saying alcohol addiction wasn’t that bad because a study on the negative effects of alcohol did not include anyone who died from alcohol related causes.

  4. You know what absolutely terrifies me? The legions of people commenting on this study on ny times and other sites, claiming how incredible antidepressants are and how they saved their lives. Sometimes it makes me feel broken or like I am missing out on something being off of them. It’s strange because it took me years to finally taper off. Someone commented on the ny times article saying they didn’t even know they were depressed until they started taking an antidepressant and realized how great life could be. Very triggering

    • To dreamer0 that’s because antidepressants create a temporary euphoria in the first weeks or months of taking them. But in the long run they create emotional and spiritual numbing at best and a very profound dependency of the nervous system upon them. They actually change the architecture of our brain and it can take years to taper off of them because it takes that long for the brain to revert to its pre drug structure.

    • I was prescribed antidepressants when I was in my early 40’s and was going through a life crisis, the situation after my divorce and children going to live with their father. My psychoanalyst at the time, saved my life-not that I was suicidal, I wasn’t, but through the theraputic alliance, his authenticity and faith in me, I blossomed. Returned to grad school at age 60 to begin my journey to become a psychotherapsit, now age 80 in private practice. I think the medication helped me through the crippling anxiety and debilitating shame that I was then able to work through. Medication is not always unhelpful.

  5. I was prescribed antidepressants when I was in my early 40’s and was going through a life crisis, the situation after my divorce and children going to live with their father. My psychoanalyst at the time, saved my life-not that I was suicidal, I wasn’t, but through the theraputic alliance, his authenticity and faith in me, I blossomed. Returned to grad school at age 60 to begin my journey to become a psychotherapsit, now age 80 in private practice. I think the medication helped me through the crippling anxiety and debilitating shame that I was then able to work through. Medication is not always unhelpful.

  6. Many times, that white women are more likely to receive diagnoses of depression and are thus prescribed antidepressants is because of all the “groups” of people, white women have usually felt more comfortable receiving psychiatric therapy. Additionally, white women are much of the time, prescribed antidepressants for many “change of life episodes” from post-partum depression to menopause. In many ways, this is just a tragic artifact of the system. In my opinion, it has nothing to do with alleged white male authoritarianism or whatever. Many of the prescribers of these drugs are actually women themselves. We do ourselves a disservice by singling out specific groups as the “bad guys” behind psychiatry. Yes, most of the earliest psychiatrists, etc. were white men, but we are behind that now. Maybe, it’s me, but I’ve had much more grief from women than men. We need to look at the whole situation. We need to look at the psychiatric community, the Big Pharma community, and the “patients and family” too. Personally, I don’t think these drugs do any good. I think they, in most cases, do more harm than good. In addition to the side effects and the withdrawal from the drugs, these drugs, like all psychiatric drugs and even therapy, etc. hide much of what really needs to be addressed by the patient. As I have said earlier, it is the easy way out. And sadly, so many are so desperate because they have been brainwashed by media and others, they will take any way they can to get out of their misery, even if in the end it causes more misery. Thank you.

    • Just to be clear, “white male authoritarianism” can be and is enforced or enacted by non-white people and/or by women. It is the “thinking” or the philosophy or the “system” behind the actions that is authoritarian, and that system was most definitely constructed by white, male authoritarians over many decades or even centuries. The question isn’t who is doing it, it’s more who is impacted, and history shows us that women are regarded “by the system” as being more “sick” or “disturbed” or “mentally ill.”

      Consider the idea of “hypersexuality.” That concept is almost NEVER applied to men, but is a big “problem” for women, according to psychiatry. This reflects male privilege in our culture, in that men who sleep around are considered “players” or “studs” or “Ladies’ men,” whereas women who do the exact same thing are considered “sluts” or “whores” or “slags” or any number of unflattering things. No man was ever diagnosed with anything because he slept around.

      That’s just one example, and it’s very clear that women have long been a part of enforcing this condemnation of women who are “promiscuous.” The term I think that applies is “internalized oppression,” where members of an oppressed group are expected to enforce “norms” that come from the group in control in order to avoid punishment themselves.

      So in my view, psychiatry incorporates many biases and prejudices about women from the general society, and as a result, is even more likely to attack women than men for being “different.” It is also clear that racism is part of the underlying structure of psychiatry, as the disproportion of black people being diagnosed “schizophrenic” is way higher than the general population. The fact that black psychiatrists may participate in this set of discriminatory practices does not make it any less racist.

      I hope that makes some sense.

      • Yes, you are right to a certain extent. I say that because, believe it or not in some areas of the South, a man may not necessarily get a diagnosis of something like “hypersexuality” for “sleeping around” as they say. He may just be called an “alcoholic.” If he doesn’t drink, he is called a “dry alcoholic.” And behind his back, he is described as someone who won’t keep his “you know what” in his pants. He is looked down upon, too and is probably not trusted. But I will say in many ways you are right. In my opinion, it is a complicated subject, and it has been definitely complicated over the last decades as women began entering the work force. I think that perhaps many thought the pandemic might compel women to return the traditional way; like an old 1950s sitcom. However, many women were so stressed with handling their children’s learning, the housework and also holding down their jobs virtually, they were more than happy the way things were just before the pandemic, not trying to adapt 1950s morays to 21st century technology. I just think that even this men/women thing can be successfully questioned. Despite what seems there is a lot of nuances involved and we should be willing to engage our minds to see that. Although in many ways you are correct, we must still be opened to the uniqueness of each person and situation. There a re millions and millions of little subcultures with all kinds of various morays. And yes, even those subcultures are still heavily influenced by whatever the prevailing or conquering culture at the time is. Thank you.

  7. I understand why some people want to criticize alleged white male authoritarianism and implicate it in the evils of psychiatry. And like I said earlier, there have been many white males who have definitely contributed to the evils of psychiatry. However, I am completely reticent (I hope that is the right word) to implicate any particular group of people in a negative manner. Yes, the European/American culture has been basically patriarchal. And there are implications to that and like all things both negative and positive. However, I do find that implicating an entire group in a negative light, such as white males, really does nothing to solve the problem of psychiatry or any of the current problems we face in society. In my opinion, the best way to solve the problem is to consider each person as an individual and see what they can offer, rather than disparaging any particular group. In my opinion, on the whole all groups do share guilt and responsibility and are also innocent and victims. Life and living are inherently paradoxical. This is one truth psychiatry seems to avoid, as they say, “like the plague.” Thank you.

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