Antidepressants: Widely Used, But Practically Useless?

In yesterday’s article entitled Drugged-Out Nation, I mentioned how antidepressants were the third most popular class of drugs dispensed in 2008, with over $9.5 billion in sales.

And over the last ten years, their use has nearly doubled in the U.S., while the use of psychotherapy by those prescribed antidepressants has declined.

Ten percent of the U.S. population is now being treated with an antidepressant during the course of a year, whereas ten years ago, five percent of the population was being treated with antidepressants.

One exception to the trend involved African-Americans. Ten years ago, 3.6% of African-Americans were on antidepressants and currently that number stands at 4.5%. The reason for this, according to some studies, is that African-Americans have lower rates of depression than whites.

In regards to psychotherapy, ten years ago 31% of people on antidepressants also took part in psychotherapy. Now the number of people both taking antidepressants and participating in psychotherapy is 20%.

There are a number of factors that explain the increasing use of antidepressants. One is that there has been broad and growing acceptance of antidepressant medicine in the U.S..

The other is that over the last ten years, several new antidepressants have come on the market, and they’re big money makers.

Unfortunately, it’s well-known that in mild to moderate depression, psychotherapy is as good as or better than medications. And in the population as a whole, most depression is mild or moderate.

Yet, antidepressant use has skyrocketed while psychotherapy use has declined.

And now new research has shown that half the people who take antidepressants for depression never get relief.

Why? Because the cause of depression has been oversimplified and drugs designed to treat it aim at the wrong target, according to new research from the Northwestern University Feinberg School of Medicine.

A study from the laboratory of long-time depression researcher Eva Redei has toppled two strongly held beliefs about depression. One is that stressful life events are a major cause of depression. The other is that an imbalance in neurotransmitters in the brain triggers depressive symptoms.

Both findings are significant because these beliefs were the basis for developing drugs currently used to treat depression.

Redei, the David Lawrence Stein Professor of Psychiatry at Northwestern’s Feinberg School, found powerful molecular evidence that quashes the long-held dogma that stress is generally a major cause of depression. Her new research reveals that there is almost no overlap between stress-related genes and depression-related gene.

And antidepressants treat stress, not depression. “That is one key reason why current antidepressants aren’t doing a great job,” Redei noted.

She said another reason current antidepressants are often ineffective is that they aim to boost neurotransmitters based on the popular molecular explanation of depression, which is that it’s the result of decreased levels of the neurotransmitters serotonin, norepinephrine and dopamine. But that’s wrong, Redei said.

“The medications have been focusing on the effect, not the cause,” she said. “That’s why it takes so long for them to work and why they aren’t effective for so many people.”

And so, in our drugged-out nation, we have so many people taking antidepressants, and yet the great percentage of people taking them should not be.

But why should the drug companies care? They’re making healthy profits off of depression.