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A Group led by Professor Irving Kirsch, at the Department of Psychology at the University of Hull, looked at 47 clinical trials using data from Freedom of Information rules by the US Food and Drug Administration. They looked at the most commonly used anti-depressants such as fluoxetine (Prozac), venlafaxine (Efexor) and paroxetine (Seroxat).

They found that these anti-depressants had no greater effect than a placebo for mildly depressed patients and the majority of people suffering severe depression.

This new group of anti-depressants are called selective Serotonin re-uptake inhibitors. If the blood serotonin level is low, you feel depressed. These drugs improve this. The study confirmed that depression improved with these drugs but patients also improved with dummy pills. In other words depression will improve without chemical intervention.

Prof. Irvine Kirsch said, “Given these data, there seem little evidence to support the prescription of anti-depressant medication to any but the most depressed patients unless alternative treatments have failed to provide benefit.”

Nine out of ten GPs admit that they are forced into dishing out prescriptions because of poor access to treatments such as cognitive behavioural therapy. In Chelmsford the waiting time for CBT is very long.

Although there has been numerous side effects linked with these drugs and suicidal tendencies associated with prozac and seroxat, they are an improvement on the older drugs. GPs over prescribe these drugs and this research will change the prescribing habits across the country. It is certainly a step in the right direction if patients are given coping mechanisms to control depression. If and when depression recurs, they will know what to do for themselves rather than expect the magic pill to sort it out.

There are numerous times that I spent over twenty minutes talking to a depressed patient and prescribing the drug they expected from me and when they return for a follow up, they admitted that they did not take their tablets but took on board what I said, changed a few things in their lives, and that felt much better. There are also quite a few elderly patients on these drugs. They get their repeat prescriptions every month and stack them up in their cupboard and show no signs of any change.

This research result will not just save the NHS money in reduced prescriptions, but will change patients expectation. They will know that to get better, they should first heed the statement of two letter words. “If it is to be, it is up to me.”

Dr. Phil Hariram.