New research on the Public Library of Science web site about the effectiveness of antidepressants recently made front page news with at least four UK newspapers (Guardian, Telegraph, Independent and Times) and the headlines made worrying reading.

“Antidepressant drugs don’t work – official study”, “Prozac, used by 40 million people, does not work” and “Depression drugs don’t work, finds data review” were headlines from the newspapers and the journalists reported that the drugs covered by the research (Fluoxetine, Venlafaxine, Nefazodone, Paroxetine, Sertraline and Citalopram) were ineffective and "had no more effect than a dummy pill for people with mild or moderate depression" - Times 26th February 2008. 

Having read the research I think the media reacted irresponsibly in writing such headlines and my opinion is that they misrepresent the findings of the research and perhaps miss what for me an important part of the researchers conclusion. The research concluded:-

Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication. -  Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration

If the conclusion of the research is correct then not only does this potentially question the effectiveness of SSRI medication but also alternative medication such as St Johns Wort. alexander technique and yoga. Maybe those who have benefited from St Johns Wort might have been better off taking smarties?

My personal experience is that both Fluoxetine and Citalopram have provided me with real benefits and to be honest if St Johns Wort and the success of alternative medicines were down to the placebo effect then I really don't care. As long as nobody gets harmed I think the most important thing is that people get better.