I do realize that there are various conditions where individuals would struggle without medication, that most conditions are not made to sell pills, but feel we all need to be aware that there are 100s of fad treatments. Medication is not always the only choice.

I grow up with a mother who was on medication all her life, not being able to be a real mother. She was so misunderstood, miss diagnosed so many times, her life consist of taking a drug(s) upping the dose, changing the drug and the circle went on She always felt like she never belonged in this world, no one seem to understand and consequent of this, she was never happy and never able to be a mother to me.

I am not a professional but do know when my mother was given drugs she quite often became more suicidal, and we was told at one point that drugs for depression can make manic depressives worse, I also feel now she had aspergers (see asplanet.info) Drugs never allowed her to find her true self, she never felt she belonged...

Alyson Braldey , Cashmere, Christchurch, NZ

These findings only reiterate the obvious, drug companies are pertinacious in all motives for the almighty buck !!!!

robert murphy, springfield, ma

People with longterm depression that appears to have no reason often have a chemical imbalance. I echo the sentiment of another poster who comments that the drugs never cure people....

Applied kinesiology might be worth a try for those of you in this bracket. It claims to be able to detect precisely what your neurotransmitter deficiency is. I'll be giving it a go after 17 years on the SSRI merrygoround.

Jamie, Derby ,

There is an interesting post on this blog site: http://scripeditorblog.blogspot.com/

"Could the problem be with depression itself? With a disease so subjective, is it any wonder that more and more patients are being diagnosed? Could it be simply that many patients are being diagnosed with depression who are merely "down", "blue" or grieving? Maybe their depression would resolve eventually anyway. "

Toby Charkin, London, UK

Many of the "I know how SSRIs helped me, I could never come off them, I've tried" type of commenters here are completely missing the point.

You were consciously aware that you:
a) you were taking pills and
b) that they were were SSRIs.

If you were taking placebos you would be consciously aware that you:
a) you were taking pills and
b) you would think you were taking SSRIs when in fact you wouldn't be,

What the placebo effect tests, which in all the comments of personal experience I have yet to see one example of, is what would happen if you *believed* you were still taking SSRIs, but weren't.

Now most of you will probably still persist with the logic that since you felt so dreadful when you came off them, you'll still feel worse as your body would know, even if your mind doesn't.

But I see no evidence that any of you have tried this, or have had it tried on you (if you know you're taking a placebo, the test is nullified of course).

This study is evidence to the contrary.

Laura Roberts, London, UK

What a load of rubbish that a placebo is as good as SSRIs! Only those people who have been severely depressed should be commenting here and will know that these drugs can be a god-send. I'm fed up of reading the comments of people who have no idea about how bad depression can get. Of course the drugs won't have an effect if you're not actually properly depressed in the first place!
I once had depression returning after an attempt to come off SSRIs. I had been OK on a particular dose and was convinced that going back on that dose would make me better again. However, it didn't and I had to go back onto a higher dose which then worked. This is an example of the complete opposite of a placebo effect and goes towards proving that the drugs DO work.

Fiona, Maidstone, Kent

horses for courses - everyones chemical make-up is different - so the effects will never be the same on every person. i myself suffered with depression for many years kept going back to the doctors - each time walking away with a different prescription for another pill.....my depression got real bad so out of desperation i took it upon myself to search out a "magic" pill / cure - compared the write ups, (THANKYOU google ) looked at results of trials etc ( i did not want to die anymore)... - there was no magic cure - but i kept coming up on what looked like it could be the ONE. couldn`t dig out any dirt or negative comments...summed up the courage and went to my doctor and asked for Citalopram, he prescribed me 10mg tablets - within days i started feeling better, and within months i was back in the swing of life.. its been almost 16months since i had my last pill and i haven`t felt better - all i can say is the last 5 years have been the best years - i can cope with everything NOW

T, London, UK

Clinical depression has been on the private and public discussion menu for decades; there's probably been more published about this than about any other, potentially fatal, illness. It seems surprising therefore that so many people - perhaps the majority - still believe that it is without pathology and that getting more fresh air, bucking up and just jolly well living more sensibly is going to do the trick. I appreciate the comment about depressives needing TLC, but a depressive is not the world's easiest person to love and TLC runs out PDQ after the 100th rejection.

The rationale of your article is proved in these responses: if you're genuinely depressed, antidepressants help. If on the other hand you're unhappy, that is not a clinical matter and does not require, and will not respond to, clinical treatments.

My depression is genetic, derives from epilepsy, and has a very clear biological pattern. Antidepressants cure nothing, but they keep me alive and more or less tolerable.

amanda, aix-les-bains, france

I have just finished running a 6 week course of CBT/self image psychology for 12 of the most depressed patients at my local GP surgery as part of the IAPT trial.
The results have been brilliant and the improvement that these folks have seen to their lives beneficial. Some remain on antidepressants but now have new tools to help them tackle the challenges that life presents.
Sadly the funding has not been available before - and this is only a pilot- but maybe now the government will be able to justify providing access to talking therapies rather than purely drugs.
There are thousands of trained counsellors out there already, many of whom work for little or nothing in the voluntary sector, due to lack of funding for vital work.

Sheila, Bournemouth,

I am a Director or Psychiatric Nursing, Main area of work in Older age care, but i have practiced in all areas in Both Australia & the UK.

A GP may well reach for the prescription pad, but the manipulation of the body through medication, does not address the issues causing the depression itself, unless it is a pure bio-chemical imbalance with no obvious life event cause.

Community Psychiatric Nurses are very well skilled to support, through commnity based groups, Individual theraputic aproaches, & often have taken specialist courses in specific areas, for all age groups. Likewise, Therapists or Psychologists...but the problem is massive cuts in funding of these services. Many are restricted , have long waiting times, or are simply not funded. Often the Voluntary Sector provides the support, but they are also very stretched.
From my experience, the cause of the distress needs to be addressed, often caused by life events. A pill does not take this away...

Mark, London , UK

I personally am taking anti-depressants at the moment and in no way has it sent me 'crazy', they have helped me in such a way that I am able to function on a 'normal' daily basis. I have taken different kinds of tablets to find the one that 'works' for me and at no time was I just given a pescription, I was explained the process of anti-depressants and how it treats the chemical inbalance within ourselves and was told to go away and think about it before i started taking any pills i was also offered counselling/therapy throughout my treatment to deal with the emotional side.
I personally do not believe that anti-depressants are just a 'placebo' as it took me along time to believe that I would benefit from them and since taking the tablets have never looked back. They can work in a way that anyone taking other medication would and feel that the stigama around mental illness is bad enough without having to think about what i am taking 'is just a figment of my imagination'.

Claire, Loughborough, Leics UK

Interesting debate.

Some background points. By 2025 the biggest drain on the NHS will be mental health issues, the nation is going mad. In order to combat this we have to start now.

Depression is something that pills will not cure. The depression is hiding something the individual is not addressing, mentally. Help with that something (self esteem, knowledge of self, relationships etc etc) will remove the depresison.

Perhaps the government will use the well documented "Make Slough Happy" and weave happiness into everything we do. We need a paradigm shift on what the word depression actually means.

Marc, Hull,

GSK have not long released a statement (http://www.pharmatimes.com/WorldNews/article.aspx?id=12950) regarding this study. It is a statement full of spin.

Here's a snippet:

...In addition, however, GSK responded to a request for data on the use of paroxetine in children. The spokesperson noted that the company provided a list of the studies that had either been completed or were underway, ?however this was an unlicensed indication and was subject to an ongoing regulatory review by the Medicines and Healthcare products Regulatory Agency. It was therefore not appropriate to provide these data to NICE ahead of the MHRA's conclusions."

I would like to make it abundantly clear that the MHRA are NOT conducting a regulatory review - it is a criminal investigation!

Quite unbeleiveable

Bob

SEROXAT SUFFERERS BLOG
http://fiddaman.blogspot.com

BOB FIDDAMAN, Birmingham, West Midlands

I have been taking Efexor for many years now. I had a history of depression from an early age. My brother and mother also suffer from depression. It has been established that I have a low level of seratonin. Before I began taking Efexor, my world revolved around my bedroom. I would not go out during daylight hours, and regularly contemplated suicide. There was no obvious reason behind my depression, and somehow, that made things worse. Three weeks into taking Efexor and I felt.. elated. This naturally balanced out, and I can now think and behave like any *normal* human being. I have tried on several occasions to come off the medication, but each time, I return to my previous world. Somehow I cannot see a placebo making any such difference in my life.

Jo, Glenrothes, Fife

Clinical depression is a very real, and still largely misunderstood disease. It's not about thoughts, happiness, sadness,self control and fresh air. It's about imbalances in brain chemicals created by some strong stress, trauma or even other medical conditions. And for those who've been through it, it is absolute hell. And mostly curable.
Yes, taking anti-depressants does make it worse at first -- it does the same with antibiotics, or chemotherapy or whatever. It's not magic, it's a cure that takes time. The point is not to blame the drugs, it's to blame the diagnosis or the doctor when it does not work. Clearly, if placebos are seen to be working as well as prozac, those patients needed some other kind of treatment. Ditto patients who end up addicted; they need to change their doctors and not the meds. Studies like these, while valuable, tend to skew misconceptions about the disease itself. We don't need that, it's hard enough as it is.

su, london,

Interesting considering that the amino acid L-Tryptophan was once commonly used to treat depression before the FDA banned its public sale due to a contaminated batch shortly prior to the launch of the SSRI Prozac in 1990. Yet l-tryptophan was/is still authorised for use in hospitals, infant formula and animal feed.
L-tryptophan is found naturally in food sources, eg turkey, it works by enabling the body to produce more serotonin, whereas SSRI's work by merely enhancing the existing serotoin which is usually depleted or practically non existent in those with depression - this would explain why SSRI's do not work for a large majority of users.
More info can be found by looking up Politics, Profits & Prozac and psychiatrywithoutdrugs.co.uk/tryptophan.htm. There is also The Mood Cure which looks at treating mental health problems through the use of various amino acids and nutrition. Afterall brains are like engines, you've got to put the right fuel in to get optimum performance out.

Sarah, Leigh, UK

Lucy: you know no one who has been helped by medication for depression---end of story then? As it happens a close friend of mine sufferd from depression for his whole adult life---therapy proved utterly useless--and finally emerged from disabling depression after taking an SSRI. He hasn't looked back.

Dectora, London, UK

i became seriously depressed after my marriage break up. was prescribed anti depressants but was too afraid to take them as the warning was - "they may make you feel worse at first! "
i couldnt afford to feel worse! Idve been 6ft under!
With the help of a very supportive friend/ time/ being gentle with myself/ fresh air/exercise good food & no alcohol!! - I gradually got better.
I am now a Rotweiler! Wouldnt like to go through that again but drugs are not the answer.

deb, barrow in furness, cumbria

Pleasingly timed to coincide with the ministerial announcement to train extra cognitive behavioural therapists.
I wonder what the effectiveness of these therapists has been shown to be?
Are they favourable compared to medication?
Have they been shown to work in everyday settings, or in university research trials with exclusive, non-representative samples?
Whom will they 'treat'?
Who will supervise these therapists?
Will service users be given actual choices, or only a choice between medication or new CBT therapist?
Let's wait and see, eh?

Pete, Oxford, England

I think the government or companies funding the research just want to look for a reason to stop paying for the medication.

Tim, Toronto,

It's bad enough having to be on anti-depressants, with all the stigma attached, without the government saying they don't work! I don't want to take pills but I know they work as I've tried to come off them several times and had relapses. Counselling made me worse at one point! As usual, it's complicated and different things works for different people but I wish those concerned would acknowledge the very positive difference they can make for families and marriages whilst other ways of treating the depression are explored and the doses can be decreased slowly.

Helen, Huddersfield, England

From my experience...

Anti-depressants are not a miracle drug, they can potentially aid certain people in certain situations to overcome or control a bout of severe depression.

Anti-depressants don't make you happy, they are not pleasant to take because they can make you feel very strange and unlike yourself. However, by emotional numbing, they can help to give you a break from the constant negativity and blackness that can run through your body and mind, when you are in the clutches of severe depression.

After a few months on fluoxitine I had regained enough energy and mental strength to take control of my life again.

I would use them again, but only if I had really severe, crippling depression. However, over the past 2 years I have managed to keep further bouts of depression at bay through a change in mental attitude and by respecting my bodys chemical processes by eating healthily and taking exercise.

Tabitha, Rugby, UK

There is little doubt that the most expensive placebo fed to the public over recent years is wind power – with hundreds now operational our power stations still burn the same amount of fossil fuel on windy days as they on windless days. But please do not tell the green soothsayers - as without this placebo they may all turn to Prozac or Seroxat.

Brian Christley, Abergele, UK

I have been on and off prozac/venlafaxine etc for YEARS. Eventually, I went to a psychotherapist, as my GP was worried I never got better permanently. The NHS specialisy was useles, and referred me to a sex therapist. Nonsense!! So I went to a recommended hypnotherapist and i was cured very rapidly,I do not have a se problem, and I am free of the depression I have had on and off for50 years I feel 30 again in my mind! It might not work for everyone, but well done on this survy of these terrible pills.!

Piggi, Surbiton, England

Great!!! where esle do placebos work just as well? surely its not just depression!

dave simba, sunderland, uk

I can't think of one person i know who has taken anti depressants, who has actually been cured by them. They have all been taking them for years with no end to there depression in sight. It does not cure your problems, only masks them.

lucy, london UK,

Liz: How can a pill cure a thought?

You are right - it is not the pill that physically cures the thought. It is the thoughts that the pill generates that in turn cure the "bad" thoughts. A person suffering from depression focuses on and looks for negative things. They take a pill which they think is going to make them happier, so they start looking for that happiness to kick in . And so the upward spiral of positive thinking starts. Whether it is a "real" pill or a placebo is actually quite irrelevant.

When I was diagnosed with mild depression as a teenager, my mother went off her tree when the doctor suggested medication as a first step, claiming that i needed someone to talk to. The doctor calmly replied that if, after a few months on medication, I could still not sort things out in my own head, or didn't find talking to friends and family as sufficient, that's when you bring in a professional's ear. He was confident that the upward spiral of positive thoughts would kick in..

Jennie, Australia,

???How do you explain it when one is not expecting the drug to work, but it does? The placebo effect is supposed to occur when a person believes the drug is supposed to work and they experience relief due to their beliefs and expectations. SSRIs have given many people relief from the pain of depression and a new lease on life. And also, ?I m not sure where this idea of "pills vs therapy" is coming from??? When you respond to "pills", the relief from depression, which can be a debilitating disorder, provides an excellent opportunity for the consumer to accomplish and achive things that they, otherwise, would not be able to do. It also provides an excellent emotional environment for work with a therapist as the consumer, who may no longer feeling helpless, is far more able and willing to help themselves.

When "pills" are prescribed for a physical illness, it is assumed that people need these medications and they are usually not questioned. ??? What is the deal with depression?

Jeanise, Salt Lake City, UT

I took prozac once, for a short term acute depression.
It made me feel less miserable, but affected my judgement and impulse control in quite a serious way after only 3 days which definitely was not what I expected. I stopped taking the drug, out of a concern for safety, and concentrated on bringing about change as a means of ending my depression. I'm not as free of depression as I'd like to be, but I would be reluctant to try drugs again. What does help me, is visualising depression as the tool of an unseen enemy who is trying to make my life hard. The way forward then is to either fight the depression if it isn't too disabling or sleep it off if it is. At least asleep I don't make the sort of bad decisions depression can cause! I'd rather have to make my excuses for not being around for a day or two than have people interact with me when I am really miserable. I found that over the 12 years I've been doing this, my depression has become much less powerful. I hope that helps someone

Steve C, birmingham,

Now that anti-depressant medications are costing the UK's socialized medical plan millions, they suddenly "don't work."

Kate, Phoenix, Arizona, US

My brother suffered a nervous brake-down in 1991 which was accompanied by depression and hallucinations. The doctors immediate reaction was to prescribe meds which only exacerbated his problems.

After taking the anti-depressants, he complained of dizziness, nausea and would walk around doped all day.

My mother, who is a registered dietitian, with years of experience in the health industry, fought his doctors and rescued him from these poisons.

His diet was improved with high vitamin intake and natural supplements and more exercise, and he has been medication free for 17 years, happy and healthy.

It has become a knee jerk reaction for doctors to prescribe meds for patients and it saddens me that natural methods are being ignored for cures that only generate revenue for these monster drug companies.

Mark Stephens, Maidstone, UK

I personally have had less-than-positive experiences with 3 different anti-depressants. I cannot personally recommend them to anyone. One was so bad I felt much worse after I stopped taking it than before or during. An additional side-effect was an incredible increase in my libido, a disabling increase that left me feeling not only constantly sexually over-stimulated for months, but also so ashamed I hesitated to tell anyone. No doctor warned me of this.

I'm glad doctors are finally getting the word to slow down on prescribing SSRI's like candy.

I have come to believe depressions are natural occurrences to what is going on around us, and some of us (like me) are naturally more "depressed" than others all the time. Perhaps the old Roman Catholic teaching of simply learning how to endure bad events well is a better idea. One can be "depressed" and not be unhappy.

Name Withheld, SC, USA

I'm an American living in the UK, and have been on an SSRI (Sertraline) before for severe depression and anxiety, which seemed to help. Recently I've been struck again, and went to my GP who happily prescribed the same med without spending even 10 minutes with me. Got the med, took it, and it made me crazy this time. I mean, CRAZY - much much worse than before I began it.
I quit the pills and went back to the GP to see why it seemed to work so well before, and it did the total opposite this time. She said it's probably because I'm not nearly as "depressed" as I was before, so it's making my chemicals go all out of whack. I just thought it was interesting, and somewhat disappointing that my GP would so easily prescribe medication without even giving me the option of really figuring this problem out. I'm not saying pills don't work, but I'm quite shocked at the ease of getting anti-depressants when I may not even need them, and without being given any ideas for other treatment.

DM, Folkestone, UK

Depression is a spectrum. Some sufferers have mild, come have severe, some recurring. They are all prescribed antidepressants. Obviously their effect will produce a wide spectrum of oputcomes as a result. They do have a valuable place in medicine, and as someone who has used them, I would not have been able to be where I am today without them. As with any drug, there are dangers, but life is a weighing up of risk.

Also, there are more people than ever going to their GP complaining of depression, and the consumerist socitey we live in demands results and intervention, when possibly in former times, we would have had to live with the rough times.

Most people will have to go through some period of depression in their lives, it is a natural human emotion. Interestingly our nation was happiest post world war II, when communities were working together towards a common goal, so maybe the problem is more complex than a prescription??

Elizabeth Little, Glasgow,

I have never used SSRIs but am around people that do. The sad thing is the people taking them say the make them feel better.

But, the change in personality the weird stares sometimes scary and the fact that they look like they are doped up all day makes me wonder why they take them. I guess feeling high means feeling good to them.

Polchgs, Austin, Texas

Interestingly the 'placebo effect' has been discussed before in 1952 by Hans Eysenk who suggested that 2/3 of patients benefited from psychotherapy, while 1/3 the ones who did not recieve therapy recovered spontaneosly. It was a controversial study involving only 24 studies, but the one that started off the 'placebo effect' discussion. There has been meta-studies analysing Clinical Research and the data included a range of studies. Eg Kirsch and Sapirstein (1999) who concluded that 25% came from the effect of the drug, 25% came from the natural healing process, and about 50% came from the expectancy effect (or placibo). So on its own a drug is not going to be very effective, but with Clinical Administration and Care it is effective. I'm of the oppinion that a patient should be on anti-depressants for a limited time as it should be regarded as a crutch (for say 6 - 12 months) until other learned behaviours of a holistic kind can be tought, and the drug reduced or withdrawn.

david davies, Edinburgh,

CR ,London is right..I can honestly say that in all the years of being depressed. I have taken pills maybe five or six times., for a period of two or three weeks.People might say,well you can't have been depressed.Believe me I was.Hiding in bed, really ill.My teenage years were just dreadful.Whilst other students were enjoying themselves,I was ill. My family has a history of depression and suicide. The only answer is proper therapy.I am lucky that I could afford to go and talk about my feelings of despair.Now in my late fifties I still have bad times but I would never ever think about taking pills.Alternative therapy can also help.Taking pills is not the answer.I've seen people end up like zombies.

Jan, London, England

how can exercise help with depression when one is so seriously depressed that you have an inability to get out of bed, or do daily activities such as prepare a meal, or make a phone call - let alone march yourself off to the gym for an anti-depression work out!

T W, sheffield,

how can a pill cure a thought, may I ask? After all what is depression if not sadness & hopelessness? If a problem exists no amount of antidepressants can cure it but dealing with the problem is a start. I have found the best cure for depression and his name is Jesus...try Him...ONLY He can take away any heartbreak, pain, hopelessness, whatever it is He can set you free.It works.

liz Cutajar, Marsascala, Malta

I beleive (as a clinical depressive since my teenage years) that this report is going to make real clinical depressives give up their medication as they will no longer feel that it works.
I personally feel as though i have cond myself and my doctor as i truely beleived it worked for me.
I take 40g per day and was told as i fluctuate so much with mood that i would be likely to be on pills for the rest of my life.
I struggle daily with the understanding that i am a depressive & with the need to continue medication as when i am on prozac i feel normal . If i stopped, i know i would quickly become suicidal and quite a desperate person.
This report is very hard to read and makes me feel like a fraund. Being a clinical depressive is to questions ones self continually about allsorts of things, like self worth and this report has not helped anyone. I beleive there will just be a lot of people out there now stopping medication that does help them and no doubt people will loose lives

chris thompson, Barwell, UK

Bizarrely, I would rather take the shortcut to mental health.
Kay, London,

Yes, I do find that bizarre. Why on earth would you prefer a drug-induced shortcut, which as you know full well MISSES the healing process, MISSES working through what is putting you down in the first place? Oh yes, because it's easy.

CR, London, UK

I know 6 people who have taken these drugs.

Every one is still on them, after years and years.
Every one says they can't imagine life without them, and would be terrified if they had to come off them.
As an observer to their behaviour, I can say that when they started taking them, each person became "strange" and even more depressed.
The increased depression made them worry even more, and panic and be extremely anxious all the time.
They continued taking them, and they've all changed. They all seem hyper, they talk loudly, they can't relax, their attitude to others seems brutal, they can't hold a relaxed conversation without going off in all directions and figeting.

Pop a pill that makes people think they get happy, and get hooked with an immense fear of ever coming off it. My god, a drug manufacturers dream.

Tom Franklin, London, UK

Is it just possible that sedating depression where it is perceived, simply delays the treatment of a psychological illness in sever cases? Hopefully the move to train 3,500 therapists to address alternatives to treating depression with drugs, won't simply be an attempt to persuade the drug companies that their drugs are too expensive. A budget of £291 million in 2006 spent on antidepressants, sounds like an awful lot of money for a population of around 60 million. Reducing this expenditure by 10% is a token gesture, surely.

D Shotton, Bristol, Somerset

one doesn't have mental illnesses , one has diseases of the brain or toxic shock syndrome.. Why else would anyone use the west country train system.

rwn, muston,

Everyone has to overcome depression. Drugs are only a temporary measure just to give the sufferer a taste of what life is like when you are not depressed! Physical exercise, fasting and spiritual exercises are ages proven techniques which put you in control. Also, since everyone is susceptible building yourself a strong sense of identity within a community is vital.
And since we are all this life together I quite the Bavarian approach to cheering one another up; regular sessions of oom-pah-pah, beer and thigh slapping!

Paul Padley, Shrivenham, England

Realise that the people doing this study are researchers review studies not those who actually see patients,treat them and follow up their progress. Also discouraging use of these drugs would result in significant cost savings with detriment to many patients. Most of us see significant improvement with these medications and will discontinue them if there is no benefit.Patients are not going to pay for a drug if it doesn't do the job!, that is another built in protection. Drug reps arenot going to be able to persuade us to use a drug that is ineffective, that is a familiar tactic of those that want to attack medical care.These medications have revolutionized the treatment of depression with minimal side-effects

Paul Ferguson , Missoula, Montana USA

Some of these drugs destroy ones sex life. That's depressing in itself. Also I avoid drugs now and prefer to treat my own depression with Magnesium and Tribulas plus a cognetive self help approach and even self hypnotism.
Beating depression means more than drugs so I'm not surprised that this research pours doubt not their effect for the average (not seriously) depressed person.

Stephen Roberts, Cardiff, Wales

From experience I can say that the effects of the drug wear off, and the perscription had to be changed every 3-6 months for maximum effect. My question is, if they are ineffective, why is it so hard to stop taking them? I am med free for about 6 months now, and it was awful!

krs, Nashville, Tennessee USA

Why is it that no-one knows the truth concerning the effects of these drugs? Is it because so many of us, including most GPs, know so little about them an understand even less or is it that still so little is known about the workings of the brain? That being so it should perhaps be argued that none of us take any anti-depressants and many other drugs. The drug Seroxat has had a somewhat checkered history and there have been many doubts as to its safety and efficacy so this recent report comes on the back of the earlier criticisms of the drug by a number of individuals including Dr. Healey of Cardiff Medicll School.

It is not possible for patients to carry out their own individual tests on the many drugs they are prescribed by their GP. The GPs rely on consultants and salesmen. The pharmaceutical industry's main concern is profits. The patients main concern is and her good health, but where now do they go if their health becomes impaired.? Psychiatrists cannot x ray the mind.

Rodney, Lincolnshire, England UK

I've personally been on fluoextine for the last couple of years. I'm a very very sceptical person - I don't expect things to work. Prozac has definitely helped me. It hasn't changed my life, but it's allowed me to change it for myself. I'd like to think that this isn't due to a placebo effect but I suppose I have to admit that it could be.
Regardless of that, I think that some of the comments regarding depression, are clearly written by people with no knowledge or experience of the disease. Diet and exercise are all well and good, but no use if you can't bring yourself to get out of bed. I find the comments about letting nature take it's course immensely patronising. Bizarrely, I would rather take the shortcut to mental health.
There's also the fact that in the UK you certainly won't find 'talking therapy' with the NHS unless you're about to hurl yourself under a bus as soon as you leave the surgery, and a prescription costs a lot less than a shrink.

Kay, London,

After the last publicity given to Seroxat I think the only thing that changed was thhat instructions given with he drug referrd to suicidal tendencies and the the drug then being sold by its correct name 'Paroxetine' - who would want to takea drug called Seroxat after all that publicity?

Rodney, Lincolnshire, England UK

This article has cost saving efforts by the NHS written all over it. Look at the numbers: 291 million pounds sterling vs. 30 million for depression therapy. Of course the NHS wants to move to a lesser expense! But what is being compromised in the process? To all the naysayers about medication on the article, have you ever taken medication? Have you ever had depression? If you haven't tried it, don't comment on it. To those that have tried and it hasn't proven effective I am truly sorry. Anyone who has suffered the effects of clinical depression knows its a physical illness, not a case of purely a singular "bad mood". Would anyone like to ask the families of the children who died at N. Illinois University in the US, whether or not they think the gunman should have stayed on his meds?

Folks, clinical depression is as much a physical illness as cancer, and like cancer it can be treated and put into remission. The alternative is devastating for the sufferer and the family.

Chris Erdmann, London, UK

twenty five years ago I was diagnosed with bi-polar and prescribed lithium. I took this for 6 months, but didn't feel any different. Several years ago I was told by my G.P. that I should be on anti-depressents for life. I only took them for a few months. To me drugs are inadviseable and a denial of my innate possibility to grow as a person embracing all of life's ups and downs. I think that the science behind chemical inbalance is grossly flawed. We seem to want to eradicate emotional suffering from the human agenda, instead of acknowledging it, accepting discomfort and daring to try and move forward.
I know a number of people on long term medication and the drug regime seems as deabilitating as the illness, and devoid of personal progress. At worst I feel that drugs muck up the chemistry and functioning of the brain.
We have lost the confidence to progress without dubious drugs which also bring side effects that can be daunting.

peter covey, basildon, england

Hopefully what this will inform the government of is the fact that using these drugs as a quick fix is not effective. Depression is a psychological issue and cannot simply be resolved by popping pills!!!! The anti-depressants can be very useful for helping the symptoms of depression but do not cure the illness.

GP's also have the responsibility to offer more counselling to those with depression. In my experience the very first thing they offer is the drugs, adults are rarely offered counselling services therefore they are not actually addressing the problem. My opinion is that the health service think it is cheaper to have patients popping pills than offering them psychological support. These pills are very often addictive and to only offer a physiological form of help and not psychological is ludicrous and things have to change.

Clare, Glasgow,

MAO Inhibitors like Nardil work better than these newer drugs yet many psychiatrists are ignorant of their success. Pfizer has changed the medication and weakened it but it is still far better than any of these new drugs. Unfortunately the drug companies don't care as long as they can mass produce something and shove it off on a unsuspecting public. Time to weaken the power of the Big Pharmas!

mary, weymouth, MA

I know that I would not be here without the treatment I received two years ago with the anti-depressant Escitalopram, which I still take. Having suffered from depression since my teens, with varying degrees, including severe post-natal depression following the birth of one of my children, I was not able to function until I received this treatment. I know I will always have to manage my depression but can do so with the help of medication when I need it. The makers of my drug also provide additional advice and a supportive website. I do, however, applaud the extremely belated decision to invest in other therapies which can assist in the treatment of depression. Mental health services are the poor relation in the NHS and this MUST be reversed to tackle the life-destroying issues of depression. £30 million in only a start - the Government needs to do more.

Colette, Manchester, UK

These SSRIs did a fantastic job in helping me overcome panic attacks associated with anxiety depression.

The scientists who created them should be hailed as heroes.

Trailtales, London, UK

I asked my GP for therapy once. The answer was that they had to close that department at the hospital because the waiting list was too long.

You couldn't make it up.

starling, Lancaster,

These days it becomes increasingly imperative to ask the questions: who pays for the research and what are the vested interests of the funder? Viewing the University of Hull Dept of Psychology's website, there is a suggestion that the funding came from the National Health Service Trusts. With an annual spend of £110 billion, the NHS is clearly seeking cost cutting measures. We wait with anticipation to see how NICE responds to the research. It would not be surprising to find that patients would in future have to buy such drugs privately.

Dwight Vandryver, Scholar Green, Cheshire, UK

After my first pregnancy, my thyroid became underactive and eventually "packed up" about 20 years ago; I take thyroxine for the condition. In 1993, after multiple upheavals in my life, I became profoundly depressed and suicidal and was admitted to psychiatric hospital, which was a nightmare in itself.

I have been on SSRIs since then, initially Prozac which helped but made me nauseous and latterly, Seroxat, which seems to suit me. The medication plus the help of PROFESSIONAL psychiatric staff and the support of my son and my partner of 14 years has literally kept me alive.

My parents and daughter could not cope with the "stigma" of my mental ill health. Agoraphobia and panic attacks seemed to them to be evidence that I am completely mad. I try to explain my depression to those people who have a genuine concern for me thus: if you've never had a migraine, you think it's just a headache; if you've never had depression, please don't think I only need to "pull myself together"!

poohbear3931, Dartford, Kent, UK

Hello Folks, I have had a good personal experience with Fluoxetine and as a mental health worker here in the states.I have seen the evidence that SSRIs do work but should not be prescribed indescriminately.As a patient who suffers from moderate to severe depression with no suicidal ideations,I keep track of symptoms because it is easy to forget how you felt before.Talk to your physician if you have concerns about your meds effectiveness.There are options to explore.

Linnea Johnson, San Jose, California,USA

I was very dissapointed to hear this as the main head line on the morning news(bbc4). many people are depressed in this country , for various reasons. it would be wonderful if every depressed person could have counselling, or CBT when they needed it for as long as they needed it or an exercise programme to help them get out of depression, but they are just not readily available. i have bi-polar disorder, and so do need anti depressants for some of the year, fortunately i am well informed about my condition, and have good understanding, BUT the headlines today will have upset, confused, distressed many people who have trusted their GP when prescribed their antidepresssants.

dmf, opringtion, kent

This is a very depressing article.

st john fortesque-smythe (lord), london, uk

I am currently taking 150mg Efexor (Venlafaxine). It is described in most sources of information as a serotonin noradrenaline reuptake inhibitor (SNRI) rather than an SSRI (selective serotonin reuptake inhibitor). A little clarification from the authors of the study would be helpful!

I have certainly found the drug lifted my mood, although having tried a higher dose to see if it would speed up the counselling process, I found it made me extremely apathetic and detached. It is vital that patients discuss fully with their doctors what dose, as well as what drug, will help and not hinder their improvement. In the past I would have avoided any suggestion of psychiatric medication, but having tried it, I can only say that my experience overall has been positive.

Sandra, Newtownabbey, UK

I have always been deeply 'anti-pills' and have resisted taking any form of antidepressants for years, feeling that to sign my life over to a pill would be the beginning of the end and that the only way was to heal my life myself. For the last 2 years (due in part to lifestyle and social changes) my chronic depression lifted such that I barely even thought about it - the struggle to get through the day amidst mental, physical and emotional collapse was a thing of the past. Last November I had a crippling relapse which came totally out of the blue and for no reason. Winter alone could not account for it as I had all but cured myself by natural/lifestyle means and the previous winter had been fine. It has completely knocked me off my feet such that I have finally caved in and started taking St John's Wort (still resisting Prozac!) So far (3 weeks in) no improvement but I am told it has to be taken for a minimum of 6 weeks (some say 4 or 8) before it starts to produce noticeable effect.

Blue Skies, Oxford,

I don't know about the drugs mentioned in the article, but I have used the SSRI Citalopram for a while and it has made a huge difference to my life...I only take a small dosage now, but it really helped me get me out of a rut.

Chris, London,

I find this article extremely upsetting. IPrior to taking the drugs, I thought that I could get myself out of my depression and I sought help from councillors at my university and tried exercise and positive thinking, however none of this helped and suffered a breakdown around christmas of 2006. Then I was taken to the doctors by a worried mother, and I was put on citalopram. This did not help and I was prescribed Venlafaxine. This type did have a positive effect on me and I was finally able to see my problems in perspective and find a way through my issues. Along with this I went to councelling, which the doctor said that I had to have AS WELL as the drugs- neither are mutually exclusive. The effectiveness of the drugs are reliant upon a number of circumstances and can not be analysed in isolation. Everyone is different, and different methods are effective on them. Venlafaxine has helped me to clear the clouds from my head!

Fran, Leeds, England

People, you are missing the reality. The food supply is compromised by chemicals. The air and water are toxic. The economic system has enslaved everyone and central banks have created massive debt with their $ printing presses answerable to no one. The media has undermined relationships and honesty. Chemtrails fill the skys. There is nuclear and electromagnetic exposure to consider. Fake terror and war/invasion. A corrupt education system that trains conformity and stifles creative thought. Refined sugars, aspartame, tartrazine, mercury, lead, cadmium. Good luck with your brain functioning properly. Detox, Detox, Detox.

Dave, Collingwood, Canada

Whether or not the drug companies choose to publish all their clinical studies really seems like a moot point if government authorities charged with the responsibility of approving drugs have reviewed ALL the data and find the drug to be effective. Publishing all the clinical data seems pointless if one expects the public to digest all the scientific jargon and make an informed decision. Isn't that what the FDA and such agencies are created to do?

Jerry USA

jerry, chesterfield, USA/mo

I find the comments that people with depression just need exercise or a better attitude very disturbing. The people who make these comments obviously have no experience of severe depression. Drugs may not work in every case but in many others they have made all the difference and I think it would be a tragic mistake to rule them out altogether.

Anne, London, UK

Having suffered for years with an anxiety disorder I was put SSRI's as well as neuroliptic (anti psycotic drugs)

I find this report disturbing-more to the fact that drug manufacturers are withholding information- however significant it may be. Without my medication I am a different person. I would say in low doses I found the SSRI sertraline less ineffective. Maybe the people they are talking about are on low dose medication, I dont know.

SSRI's definately worked for me.

Sam, West Mids, England

Victor from Cherbourg: your mother cannot have been taking 'these' medications since your childhood, as SSRIs only entered widespread use about 20 years ago.
And as for 'therapy', a friend tried this for 30 years of his life before he tried an SSRI; in his case with very good results, but then he was suffering from severe clinical depression.
The medication did not 'numb' him, far from it---he wrote a best selling (and very good novel) after being freed from depression by medication. And to those who believe that fresh air, excercise and a positive attitude is the solution, may you suffer from clinical depression yourself, some day!

Dectora, London, UK

i have been on citalopram for well a year now i guess, and i am just coming off it.. it did wonders for me.. it really did.. it helped turn my life arround.. i am not sure about the others.. but for me there were very little side effects.. and citalopram isnt part of this study.. so i dont know where it stands.. compared to these.. at the start i was on 20mg and did nothing.. so i got boosted to 40... and the difference was slow to others but noticible to me.. i felt good and able to get out and about do things, meet people. my confidence is higher now and im more able to be normal.. i owe alot to my doctor as i hated the thought of taking tablets, but the explanation he gave me was great and that i would only be on them for year and half helped.. so i accepted and reaped the rewards..

hayley peacock, chester, england

It is about time that the veil is being pulled from the pharmaceutical company’s selective clinical trial publishing practices. I have suffered on and off from depression my entire life. Although I have been on many different antidepressants, none have "cured" me. The last antidepressant I tried, Wellbutrin, made me suicidal, even though I was not suicidal before I started taking it. It took every ounce of energy I had to resist driving my car into a brick wall. Since I was 45 at the time, I hardly fell into the teenager black box warning. Hopefully this study will make people think twice before they subject themselves to the possible harmful side effects of these drugs..

Joey B, Clermont, FL, USA

I wonder if this study considered the effects of these drugs on anxiety rather than depression? I take Zoloft for anxiety - but I also noticed that my appetite came back - and loss of appetite is usually associated with depression, not anxiety. Depression is such a generic word for what is a condition specific to each individual. If these drugs help some people - fantastic. If they don't help you - don't take them.

Holly, Chicago, IL

I disagree completely about them being a waste of time and having no affect, when i was dignosed with depression i did not know this, i thought that i had diabetis as I was always tired my memory was not to good,i was irratable, snappy and since i have went on prosac I am not so tired my memory is a lot better, i am back to what i felt about life years ago, i have more patients now i had this years ago.
No i completly disagree and have told the doctor i never want to go back to the way i was before

Terry Kerr, Aberdeen, Aberdeenshire

I disagree completely about them being a waste of time and having no affect, when i was dignosed with depression i did not know this, i thought that i had diabetis as I was always tired my memory was not to good,i was irratable, snappy and since i have went on prosac I am not so tired my memory is a lot better, i am back to what i felt about life years ago, i have more patients now i had this years ago.
No i completly disagree and have told the doctor i never want to go back to the way i was before

Terry Kerr, Aberdeen, Aberdeenshire

The dollar figures spent on these drugs is extremely low all things considered. Here in Australia we have recently made mental health counseling much more accessible by rebating about a dozen visits a year to a trained counselor which is a far more expensive proposition. Further, for all those people who can get out of bed in the morning because of SSRI's, and are made to go to their GP or mental health professional regularly in order to get a script, the drugs are performing a valid role far exceeding their cost to budget.

Shane Evans, Sydney, Australia

I was prescribed Citalopram, an SSRI last year during my first term at university. Instead of making me feel better it brought about a psychotic episode and I tried to kill myself several times. I'm just past 18, the age at which they begin to prescribe SSRI's. After this didn't work I felt totally abandoned by the system- they expected me to go home over Christmas with no treatment (pills or otherwise) for a whole month. Sort out the mental health service, its shambolic!

ACS, Canterbury,

I have suffered from severe depression but fortunately never suicidal. Prozac made a real difference to my life and recovery from about day 18 in taking the course of treatment. I think these studies must be missing something, the patient's views perhaps?

philip, London, UK

I think people turn to chemical solutions much too easily. Many people think they need antidepressants because they feel 'down' all the time - feeling 'down' is not depression; true depression is an inability to feel anything, or going from one extreme to another very quickly. Antidepressants are problematic, because people expect to feel 'happier' when taking them, but antidepressants reduce the ability to feel those extreme emotions - instead your emotions become flat - neither up nor down. If you feel down all the time it is probably your body's way of telling you that something in your life needs addressing and changing. It bothers me that a lot of people here mention being on antidepressants after the loss of a loved one; there is a big difference between grief and depression - you are SUPPOSED to feel grief, if you numb yourself to that vital emotion you will never deal with it. Why is everyone so afraid of feeling their emotions?

Coco, London,

I agree totally with Sara Kingston. I had bad experiences in the 70's with antidepresants so for years refused to take antidepressants. My problem has never been depression but anxiaty. Therefore I ended up taking phenagon every night to help me sleep. Talking to psyciarists was a total waste of time. Finally I went on seroxat, which sent me the other way I couldn't get out of bed! At last I was put on a low dose of citalapram which has worked wonders. Most of the time when I wake up in the night I am now able to go back to sleep, instead of walking around a cold house at 3 am. My husband even forgets that I am on any medication. So if this study included Citalapram I totally disagree with their findings.

Lizzie, London,

A better life is what the Doctor can't order only governments. Once they stop trying to force us through their infernal social science experiment and allow a more natural social cohesive policy the better. We wont need any drugs or any treatment just the life our forebears had.

Mark, Gateshead, UK

I speak as somebody who has taken SSRI's to treat depression. There is absolutely no doubt in my mind that these drugs make a difference. The proof is in no longer feeling suicidal and managing to live without having to battle constant anxiety. My mother has also been treated and the difference is marked. I don't buy this at all and as for a placebo effect this is nonsense. Anybody who has truely suffered severe depression and benefited from this form of treatment will tell you that any amount of sugar bills would have no beneficial effect.

Anna, London, England

I take Seroxat for periods of anxiety and depression. I have no doubt of the massive help it has been to me. The trouble with scientific studies is the don't take into account the reality of the people that have been helped in the real world. I have found myself in an extremely distressed state on a number of occasions and taking Seroxat has helped me get through those periods. Without it, I have no idea what might have happened to me. I almost certainly would have ended up unable to cope with work because when in these states I don't sleep. If only these scientists could spend some time in my (or another suffer's) shoes, they would know what good these drugs can do!

Richard, Stafford,

It cannot be true. Antidepressants have brought me out at the most terrible year. Yes there should be other treatments such as therapy but they are not available. Stop criticising the drugs, that I have seen work many times, when no other treatment is available to the majority of people.

Amber Burrows, Holyhead, Anglesey, UK

Surprise surprise. A good diet, exercise, company and opportunity will resolve depression. Some drugs may assist, most will destroy. If drug focused money was spent on one-to-one personal care, watch how quickly the depression would be resolved.

Farrukh, Woking, UK

TLC is what those sufferers need: always been the case; will always be the case.
Those pills are sale tricks, nothing else!

eddy jacobsen, L'don, UK

Placebos have been removed from the NHS armamentarium. If I wish to prescribe one in the circumstances discussed above it has to be on private prescription - the nhs doesn't like having to pay dispensing fees to a chemist doling out sugar or chalk pills. The herbalists and homeopaths now have stolen these items from NHS doctors and however desirable it might be to "kid" our patients, it is a therapeutic route now lost to us.

There is no doubt that in my 35 year career the move to ssri antidepressants has been a substantial improvement for depressed patients who do not have access to ready counselling or "psychological therapies" which are grossly inadequately provided for in the NHS and would in any case be much more expensive than 6 months of an effective drug to achieve a similar end.

Adrian Butcher, Stoke on Trent,

I found a six-month course of anti-depressants hugely helpful - they enabled me to cope which exercise and therapy on their own didn't and I would thoroughly recommend them. The causes of depression are manifold but the symptoms are chemical and can be treated chemically. Severe depression is an illness.

Helena, Oxford,

With medication i was back to work part time after two months and full time after four months. The psychiatrist said nature would have healed me but in twelve months. So medication helped nature, thank God.
G Humphries, Portsmouth, Hampshire

No, medication didn't help nature. You didn't let nature do it's amazing work, going through the priceless journey of recovery. You made a decision that nature's work wasn't good enough for you, didn't fit in with your demands and timeline, so you chose to take a short-cut with drugs. Nothing whatsoever to thank God about.

Laura Roberts, London, UK

I once had a brief visit from a Psychologist who had broken down outside my house. I took the opportunity to ask him about Saint John's Wart which seems to be a natural herbal supplement that can be taken for depression. He told me that he, nore any of his colleagues had ever prescribed it for a patient but he went on to say that "if a member of my family started to suffer from depression, thats what I would give them".

I thought his honesty was most refreshing but at the same time it shows how doctors seem to have their hands tied by protocol which seems to restrict choice or even the use of common sense. There has been a study of Saint Johns Wart in Europe and it was found to be effective without the side effects associated with many antidepressants and it probably costs a fraction of what is charged for prescription drugs.

Exercise can also be a drepression buster but that does require some effort by the person effected. We do just seem to be a pill popping society.

Graham Wharton, St. Albans, uk

A lot of these depression problems come back to your life style, as has been said, it’s your body saying that something is not right in your life and drastic changes need to be made. Ignoring what your body and mind are telling you and masking those feelings and emotions with drugs, whether they are prescription, legal or illegal, just adds to your problems!

It's no good blocking out the problems that are causing the depression, you have to tackle them head on, talk about them and try you’re very best to resolve your issues.

Taking drugs upsets your brain chemistry and can cause more bad than good for the majority of people who take them, I find that most suffers are just very unhappy with there life or have had problems and don’t have any mental issues relating to there depression.

It’s all about changing the way you think, changing your frame of mind into a more positive way of thinking. Stop focusing on the negative all of the time and think of the positives in life.

Andy T, England, North,

My mother, now 79 has taken these drugs since I was a child. They destroyed her life, her personality, her beauty and caused her to become very fat and heavy and to stay that way. Signs of senile dementia and memory loss began when she was 40 . She has been living in a nursing home from hell for a number of years now, as the family is poor.
I married a French woman, who , in turn, became addicted. Under the influence of these drugs she ran away with the children and divorced me. I eventually got the kids back into my sole custody. Damage? IMMENSE At 60, she has now lost all her short term memory capacity and I am trying to get her off drugs entirely, as the French have NO detox hospitals for tranquilizer addicts.
7 million French are addicted to these drugs. It costs the government 7 Billion Euros each year to treat them and pay for the drugs. France gets the taxes. Politicians get gifts. Drug bosses? Life imprisonment as drug dealers and swine is my wish!!!

victor Compton, Cherbourg, France

I've taken several SSRIs - Prozac, Seroxat and Citolapram. I have recurrent depressive disorder, which I've been struggling with for 20 years. I get periods of cripping depression when I can't get out of bed, and even holding a conversation with someone is too much. I have been referred to a psychiatrist, I pay to see a private counsellor. Taking exercise / being out in the fresh air / diet, etc are not enough to control my depression. Without the drugs I wouldn't be here today.

Milly, Dorset ,

I had a severe depression. With medication i was back to work part time after two months and full time after four months. The psychiatrist said nature would have healed me but in twelve months. So medication helped nature, thank God.

G Humphries, Portsmouth, Hampshire

I am a psychotherapist and have seen people damaged severely by Seroxat- , so anxioous and with suicidal ideas they did not have before they took it!- but I am told that others do well on it- it just shows that doctors must listen seriously to their individual patients! Of course 'talking therapies' given by well trained people are preferable- because they allow patients to redirect their lives, not just numb them against the pain they feel.But a properly trained psychotherapist is very expensive- drugs are actually cheaper..
Annegret, London

Annegret O'Dwyer, London, l

I note that citalopram is not mentioned - was it not part of the study? In my case, I resisted taking SSRIs for a very long time (my doctors were patient and never pushed me to take them, whilst suggesting that I might feel a whole lot better if I did). Once I did take them, I was so amazed by the improvement in my overall outlook that I wished, wholeheartedly, I had taken them months, if not a good two years, before. There are noticeable effects from citalopram - not all good, it's true - but the major one, the ability to function, is most defintely good - and real in my case.

Sara, Kingston, UK

I am a psychiatrist and very interested to see the findings of this study. There are several important things to note: firstly, 'depression' includes a spectrum of differing mood conditions - you cannot say to someone suffering severe clinical depression 'Think Positive' and cure their ills, and I have regularly seen antidepressants save lives in these cases. However, I have also seen psychiatrically inexperienced GPs prescribe antidepressants inappropriately in cases of milder depression where circumstantial and/or personality factors are more important and treatment is best with counselling or psychological therapies.

This important study need closer examination and replication before any conclusions can be made: in itself it does not provide sufficient evidence. However, it does raise genuine questions and there is clearly a case for drug companies to be forced to reveal all study data.

Russell, London,

Further proof that the drug companies and doctors have taken the public for a 'ride' . The only way to look after yourself is by proper diet and exercise.
Taking drugs basically messes up your system with all their side-effects.

louis blanc, Liverpool, merseyside

Anti-depressants saved my life - that's all I know. They've worked when nothing else has, including CBT. The problem with CBT is that it only works if your brain is under control - and it isn't always.

I worry about reports like this that some people won't seek treatment when they should.

The average waiting time for CBT is 6 months.... And it was as effective as trying to hold back the tide with my hands.

Emma Lee, Bolton, Lancs

Its an interesting article and it hopefully will reinforce the need for people to seek help and advice by using trained therapists. Unfortunately people in much of the country have only limited access to "talking therapy" with long waiting lists; so its not a case of trying other treatments first and more a case of the doctor using the only option immediately available to them.

Dr J Ward, Burntwood, Staffs

Put simply compensation. Make the drug companies, the nhs and the individual doctors pay compensation. The placebo effect of socially inept doctors, morally inept drug companies and the totally inept nhs is long dead.

Chris, Holywell,

I have suffered from depression for sometime and anti depressants did not work for me. I found being out in the fresh air, either walking, or now, looking after the animals in the field I rent, works brilliantly. Weeks of depression has now turned into the odd day, something which my family and I can cope with.

RT, Lincoln, Lincolnshire

One should look at the political implications of these findings. Not suggesting the results were rigged, but the drug bill for the NHS, actual or potential, may now be too high to allow the prescribing of SSRIs to continue or accelerate. It may be cheaper to train therapists to talk through problems.

My experience of NHS counsellors was negative when I went through a divorce. Many platitudes were expressed; the woman was inadequately equipped/trained to cope with complexity. I felt infantilised by her "insights", and I gave up. A low dose of Seroxat now helps me to see life in a more realistic perspective.

I thought it was accepted that biochemical disturbances are often at the root of psychological problems. I fear the NHS will offer its own cheap "nanny state" counsellors instead of medically trained psychologists, and depression sufferers will be thought once again to be "inadequate" rather than endocrinologically challenged.

Kate, Vienna, Austria

The government wants anti-depressant use reduced because of the cost. Universities want research grants to keep academics in work. I propose a study to prove how many studies prove what the government wants them to prove.

eric campbell, harrogate, uk

I have no reason to be depressed and yet I am. My mind is chemically unbalanced! I've tried well over 13 different kinds of antidepressants that I have actually stopped counting! The only one that did work was Prozac and I would not be alive today without it!
On some people it works and on others it doesn't. Not even the best of the best psychiatrists can tell you why though!...

Sandra, Melbourne, Australia

My wife was prescribed Venlafaxine after her mother died. She suffered severe side effects including suicidal thoughts and irrational fears, yet no-one mentioned the side effects, nor the withdrawal effect when she was trying to discontinue taking it.. Perhaps if Medics tried the medication themselves first, then they might think more carefully before prescribing them for their patients. Talking therapy seems to be far more effective for most people with depression....

Bob B, Fareham, UK

The fact that user of the medication are stating that they have been taking these medications for "years" clearly points to their ineffectiveness. Depression is not a life sentence it is a way of the body and psyche indicating to an individual that something needs to be changed in their life. Medications that effectively put people on pause, making their malaise bearable do noting to assist them make the seismic shifts necessary to repair their lives and recover.

JOn, Melbourne, Australia

I so much regret that I was ambushed by an SSRI. I wish I was back where I started from.

Peter, Sunshine Coast, Australia

I totally agree with Bill from Derby and yet again this type of reporting is incredibly irresponsible of the media. The media seems to jump on every published study in any health area without questioning its validity and seems to forget that we are dealing with a subject that impacts people's lives. I accept that the media look for news, but please a bit of balance and sense when reporting on such as sensitive area as health. People believe what the media say without question and your headlines could stop people taking their medications.

Paul G, Woodford, UK

A couple of years ago I took some anti-depression tablets (the six weeks of St. John's Wort prescribed by my German doctor didn't do a thing). Every time I took a tablet, I could feel the effect of it in my head. I only took about 9 of them because of the side effects - an extremely dry mouth and a lack of balance (I felt as though I were on some ship rolling on the ocean waves).

It was the same with the penicillin I took for the very first time when I was already in my mid-30s. Every time I took a tablet, I could feel the change in my body. I don't normally take any tablets - I don't have aspirin in the house - so I think I may be quite sensitive to such medicine.

Martina, Duesseldorf, Germany

Great, something else to be depressed about.!!!!!!!!!

Simon, Osnabruck,

There is, in my mind, a problem with studies which rely on meta analysis, a statistical trick, compounded by the fact that this study used unpublished (and therefore not peer reviewed) studies.
The fact that the study says that SSRIs work in severe depression would indicate that there is in actually an effect. Certainly there are problems with rebound depression if patients go 'cold turkey' when they feel they no longer require the drugs, rather than follow a reducing dose regimen.
It seems to me that this is a study driven by the need for academics to publish as many papers as possible every year, no matter how important or acurate.

Bill Q, Derby,

Answer to Ruth Fried's excellent question about antidepressants and suicide. Sometimes when patients begin to come out of depression they become so distressed by the mess they've made of their lives they attempt suicide. That's why I was very cautious using anti-depressants with patients with chaotic personal lives or wiith those with chronic behaviorial and characterogical problems.

MARK KLEIN, M.D., OAKLAND, CALIFORNIA

I think more should be done to make people feel more happy with them selves. Doctors are all too ready to prescribe anti depressants. I had a problems with one of my doctors and another doctor wanted me to take anti depressants, I refused but she still kept telling me they would help, I prefer to get rid of depression by natural means, doing things that makes me happy, physical exercise and being out in the sun.
People think docotors are Gods but all they do is look up symptoms in a book and prescribe tablets. I don't want tablets, they destroy you.
I say think Positive and get out and enjoy life for what it is.

Dom, northampton, UK

It seems to me that the increased suicide rate is caused by the drug giving the patient increased confidence to take action (in this case kill themselves) rather than indulge in depression induced self pity.
I was on SSRI s and I can tell you they definitely helped with my anxiety disorder and gave me confidence to face the world nd get on with life.

Dave Harris, Perth, Australia

That has not been my experience. Furthermore, if these drugs are no more effective than placebos, why are they feared to cause suicide in under eighteens? Do placebos cause suicide too?

Furriskey, Singapore,

Years ago, psychiatrists would give you a therapy session and prescribe what was thought to be helpful medication. Most of them are too sophisticated and now, they only prescribe the medication and send you to a psychologist for "talk therapy." If so much is a placebo affect, I suppose we need more psychologists and psychiatrists.

I never fully understood anyway why an anti-depressant can cause suicidal thoughts. Will someone tell me please.

Ruth Fried, Owings Mills, MD

It's very entertaining reading comments that say 'I've been taking this medication for XX years and it definitely works', for 3 reasons:

1 How would you know it's the medication working and not the placebo effect? It wouldn't be possible for you to tell.

2 If you've been taking the drug for XX years, it sounds like you have a dependence on it. You should try coming off it for a while and see if you still need it. Perhaps you're taking it for no good reason at all. A healthy person taking an antidepressant? A healthy person depressed by an antidepressant? You wouldn't know.

3 If you need to take it for XX years, it might not be a very good medication. Are you saying that depression is a permanent condition, and is incurable?

For the record, I was depressed, took Prozac for a year, then gave it up. I found my own way out of my lethargy and misery. I have strong doubts about the validity of 'bodily depression'.

Jerry Winslow, Westram, UK

I've had the big black dog for many years and I always refused to pop prozak. I had intensive psycho therapie for 5 years and slowly got rid of the worst of the depression.

What makes me feel really good is running every day, but nothing works so well as working my vegetable garden.

bob, surrey, bc

Tell me something I don't already know.....Mike.

Michael John Kirk, LURAY, Virginia

In my experience, Prozac kills your libido. Placebos do not. Perhaps, Eli Lilly should market Prozac as a revolutionary form of birth control?

Watts Taylor, Cincinnati, OH, USA

Yes, Pete from Toronto: "these people" do have a lot to answer for. I am a mental health professional (and have been for more than 30 years), and the ways we practice have changed dramatically in the last 15 years, not in the least thanks to the relentless bombardment by nifty commercials paid for by the Big Pharma, and by the culture of instant gratification and "happiness envy". Practically everyone coming to our clinic is DEMANDING medications. They "know" they need antidepressants, and do not want to bother with the tedious work of changing their daily habits of living and relating to themselves and others, which have an undeniable and lasting impact on a person's mood. We are swamped with people demanding, absolutely demanding medications: they have no time for nonsenese like "talk therapy". It is very frustrating, believe me. But most of the time we have no choice - if not us, someone else will give in.

Sarka Z Cech, San Francisco, US

I believe that this article is not saying that SSRIs do nothing or that they work only by a placebo effect. In fact, the third sentence says that they work better in severely depressed patients because of a decreased placebo effect, which means that they are in fact effective. I think the point of the article is that they shouldn't be prescribed until other methods have failed.

KH, Boston, MA

I'm an American board certified psychiatrist. Antidepressants work best with patients who have otherwise stable lives and good character. Antidepressants alone can't overcome the all too common problem by the time depressed patients appear for treatment to have severely disrupted family, marital and career relationships.

MARK KLEIN, M.D., OAKLAND, CALIFORNIA

This seems to indict big pharma and validate the public's queasiness toward regulation-free, Friedman disaster-style, greed driven corporatism. The con-men are ultimately charged, but hundreds of thousands suffer the meanwhile. The ultra-rich are held blameless, as money is fungible and the truth is easy to manipulate if one has control of the media stream.

Jim, McMinnville,

This medication is another way for people to numb themselves. Chuck "em.

Kim Righetti, Upland, Calif. USA

I've been taking an SSRI for several years and found it very beneficial, with no side effects. Hard to believe it's just a placebo effect, because i didn't expect them to work and constantly attempted to deny any beneficial effects until it was very noticeable. Who knows, maybe i'm part of a lucky minority.

dean foxsmith, toronto, on canada

I don't believe this. I am not on anti-depressants now but I have benefited from taking seroxat and prozac in the past. They worked and they felt different from each other. I also tried Venlafaxin - it was rubbish and made me feel slightly anxious and hysterical.

Luci, London, UK

it is good

bob110, new york,

As one who has taken this medications for years and have seen unmistakable positive effects, I do have some skeptisism about the sweeping nature of these findings. I certainly am aware of the possibly distorting nature of anecdotal evidence, but am also aware of the need to look at varied data sources before making the broad policy decisions talked about here.

it's very easy to get fired up agasinst the "evil" drug companies, but I hope that systematic discussions with real people who have been significantly helped by these meds are also factored into desision making.

Craig Wille, Madison , Wisconsin/USA

Perhaps Eli Lilly In