Millions of Americans take antidepressants to combat low moods. But a large, new study suggests that these medications over time may do little to improve overall quality of life.
"We found the change in health-related quality of life to be comparable or similar between patients that used antidepressant medications and those who did not use them," said study lead author Omar Almohammed, an assistant professor of clinical pharmacy at King Saud University in Saudi Arabia.
The researchers were "surprised by the results," he admitted.
However, "we are not saying that [antidepressants] are not helpful at all," Almohammed noted. Quality of life, he emphasized, is only one of many measures intended to assess health outcomes.
The research suggests patients and their doctors probably should not rely on antidepressants alone.
"We still recommend that patients continue using their antidepressant medications," Almohammed said. "But they may also want to ask their health care providers to provide them with other nontherapeutic interventions, as this may have additional impact on their quality of life."
Almohammed's team focused on a large pool of adult patients who participated in an annual health survey conducted by the U.S. National Center for Health Statistics at some point from 2005 to 2015.
In each of those years, about 17.5 million U.S. men and women respondents were newly diagnosed with depression, at an average age of 48. Nearly 58% were prescribed an antidepressant.
The study authors did not specify which antidepressants were used by which patients. Nor did they distinguish between types of depression or differing levels of severity.
Nearly 9 out of 10 patients in the study were white, most (63%) were middle-class or wealthy, and two-thirds were women. Women were more likely to be prescribed antidepressants than men (60% versus nearly 52%), the researchers said.
Quality-of-life surveys were used to track both mental and physical health outcomes for each patient for two years following their diagnosis.
The surveys assessed physical issues such as overall physical function, physical limitations, pain, overall health status, energy levels and fatigue. Mental health issues were also tracked, including the ability to socialize, limitations due to emotional problems, psychological distress and overall well-being.
The result: After two years, those taking antidepressants reported feeling no better with respect to either physical or mental quality-of-life issues than those not taking the drugs, the researchers said.
Almohammed said the findings suggest that clinicians "might be relying on the use of antidepressant medications, while underutilizing or underestimating the role and impact of non-therapeutic interventions."
Yet he also stressed that the study did not specifically explore the benefit of other types of depression treatment, such as psychotherapy or cognitive therapy. And Almohammed said the investigation cannot dismiss the possibility that antidepressants might be helpful with respect to other measures of health, apart from quality of life.
The study findings didn't surprise Dr. David Katz, founding director of the prevention research center at Yale University/Griffin Hospital, and president of the preventive medicine advocacy organization True Health Initiative.
"Overall," said Katz, "antidepressant drugs tend to be only nominally effective, even in the short term." Much of their impact can be chalked up to a nonmedicinal placebo effect, he added.
At the same time, Katz -- who was not involved in the investigation -- pointed out the study pooled all kinds of depression patients together, even though "there may be many reasons why some people received these drugs and others did not." And those varying reasons, he said, might have affected how well those drugs worked.
Still, Katz stressed that doctors' understanding of how the brain works -- and how best to treat mental health disorders -- is still "quite primitive."
While he agreed the study findings are "not a reason for patients to renounce pharmacotherapy," Katz also suggested that medications might best be thought of "as only one part -- and perhaps not the most important part -- of a more holistic treatment plan."
The study results were published April 20 in PLOS ONE.
There's more on antidepressants at the U.S. National Library of Medicine.
SOURCES: Omar Abdulrahman Almohammed, PhD, assistant professor, clinical pharmacy, Department of Clinical Pharmacy and Pharmaco-Economics research unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; David L. Katz, MD, MPH, specialist, preventive medicine, and president, True Health Initiative, and CEO, Diet ID, and founding director, Prevention Research Center, Yale University/Griffin Hospital, New Haven, Conn.; PLOS ONE, April 20, 2022