Antidepressants can help mild to moderate depression and should not just be used in bad cases, researchers say.
Research published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme has found that treatment with a selective serotonin reuptake inhibitor (SSRI) antidepressant alongside supportive care is more effective and cost-effective than supportive care alone for patients with mild to moderate depression.
In the UK, an estimated 3.5 million people take SSRIs in any one year. Currently guidelines for the management of depression, including UK NICE guidelines, recommend that antidepressants should not be used as first-line treatment for patients with depression below the severity threshold for major depressive disorder. However, general practitioners in the UK frequently prescribe these for such patients and there is little research on treatments for mild to moderate depression in primary care.
Researchers, led by Professor Tony Kendrick of the University of Southampton, recruited 220 people from 115 general practices based around academic centres in Southampton, London and Liverpool, to determine the clinical and cost-effectiveness of SSRI antidepressant treatment alongside supportive care in comparison to supportive care alone.
The results showed that supportive care plus treatment with an SSRI is more effective than supportive care alone for patients with mild to moderate depression, at least for those with symptoms persisting for eight weeks. The research also suggested that adding an SSRI to supportive care was likely to be cost-effective at the level required for recommendation for use in the NHS by the National Institute for Health and Clinical Excellence, NICE.
“Although the additional benefit of adding an SSRI is relatively small, this study has shown that prescribing these antidepressants to patients with mild to moderate depression is helpful and represents good value for money”, says Professor Kendrick. “We believe that our research can better inform GPs about when to prescribe SSRI antidepressants in primary care, and therefore lead to benefits for patients with depression.”
The report published in Health Technol Assess 2008; Vol. 13:22. To view or download the full report visit www.hta.ac.uk/project/1356
Source:National Institute for Health Research Health Technology Assessment program
