Key takeaways from a recent study on antidepressants

Posted 3 months ago by

The World Health Organization reports 300 million people live with depression, but less than half receive effective treatment.

A recent study in the journal The Lancet has been making headlines for comparing the effectiveness of antidepressant medications — information that is often lacking for patients trying to make informed choices about their treatments. They found that all of the medications were modestly more effective than a placebo and some were more effective than others. With help from our research team, we took a closer look at what these findings really mean and how they compare to what members are reporting on PatientsLikeMe.

Let’s break down the research

Researchers looked at 474 placebo-controlled and head-to-head trials including a total of 100,000+ paients on their first line of treatment for major depressive disorder. They compared the effectiveness of 21 different antidepressants to each other and a placebo. The medications were randomly assigned.

Key takeaways

  • Some antidepressants, such as escitalopram (Lexapro), mirtazapine (Remeron), paroxetine (Paxil), agomelatine (Melitor), and sertraline (Zoloft) were more effective with lower dropout rates (patients who stopped taking the medication due to side effects or other factors).
  • Medications like Reboxetine (Edronax), trazodone (Desyrel), and fluvoxamine (Fevarin) had lower efficacy.
  • The antidepressants with the highest efficacy were amitriptyline (Elavil) and escitalopram (Lexapro), while fluoxetine (Prozac) had the lowest.
  • All of the antidepressants were more effective than a placebo in treating MDD, although the effects were modest.

Some limitations

  • The majority of the clinical trials included in this study were selective and didn’t include people with more complex situations (like living with another condition in addition to MDD).
  • The study didn’t include people with treatment-resistant depression (which could be as many as 30% of people with MDD who have tried two or more medications).
  • Researchers only analyzed short-term treatment (8 weeks), so it’s unclear how the antidepressants may work in the long-term.
  • The study only looked at treatment effectiveness, not tolerability (when the medication works but a person stops taking it because of the side effects).
  • The findings were general and based on average results (across all people in the trials), so there’s little insight on targeting treatments for individuals.

On PatientsLikeMe

Here are some commonly reported ways PatientsLikeMe members are treating their major depressive disorder (MDD):

Bupropion (Wellbutrin)

  • 2,000+ members report taking bupropion (Wellbutrin)
  • 63% say that it’s at least moderately effective in treating their MDD

Duloxetine (Cymbalta)

  • 1,800+ members report taking duloxetine (Cymbalta)
  • 67% say that it’s at least moderately effective in treating their MDD

Venlafaxine (Effexor XR)

  • 1,700+ members report taking venlafaxine (Effexor XR)
  • 74% say that it’s at least moderately effective in treating their MDD

Sertraline (Zoloft)

  • 1,500+ members report taking sertraline (Zoloft)
  • 55% say that it’s at least moderately effective in treating their MDD

Fluoxetine (Prozac)

  • 1,500+ members report taking fluoxetine (Prozac)
  • 61% say that it’s at least moderately effective in treating their MDD

Finding what works for you

Many patients have tried several antidepressants in their search to find what works for them (if you’re a PatientsLikeMe member, you can check out what others have shared about this in a recent study). Some studies also show that medication may be more effective when combined with cognitive behavioral therapy. Talk to your doctor to find the best approach to treatment for you.

Are you on an antidepressant? Join PatientsLikeMe today to share your experience and learn from the community.

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One Comment

  1. I completely agree with the results of this study. It is exactly what I have found and experienced. I was on Amitriptyline for 15 years and I believe it was the best.I did gain weight but it was an effect I needed. I quit it after all those years because things changed in my personal life that made the sedation less appealing and more of a negative in my life. I was on rotating shifts at work. I went to Nortriptyline for awhile which is less sedating but it was still too much. I was put on Mirtazapine which worked really well too but I gained too much weight and decided to try another. But did like how I felt on it. After that, I had some unsuccessful trials on Venlafaxine(it made me paranoid), Duloxetine, (too disorientating), and Lexapro(I was unable to sleep). I am back on Mirtazapine but at a lower dose and I am doing great. I have only gained 5lbs on the lower dose after 5 months. I learned over the years that the “newer antidepressants” that the doctors were pushing were not the “miracle”AD’s that I was led to believe. I was also concerned about the fact that a few like Venlafaxine made things really bad for you physically and mentally if you happen to forget a dose or if decide to get off of them. People need to research these drugs and openly discuss with their doctors the effects. I have always been lucky that my doctors and I could work as a team in finding the correct one and the correct dose. I learned that in mos, a lower than usual maintenance dose worked better for me. But patients need to give them time to work before deciding unless you have really bad adverse effects. Many initial negative effects do subside. I have been on AD’s for 35 years with a few “vacations”. They have made my life so much better.

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