Psych Central


Placebo as Good as Paxil, Tofranil for Most DepressionFrom the “What the…?!” file, new research we reported on today found that two antidepressants — Paxil (still commonly prescribed) and Tofranil (not commonly prescribed) — seem to only really work for the most severe kind of depression. When prescribed for mild to moderate — the vast majority of depression diagnosed today — these two antidepressants did not any better than a sugar pill placebo.

The researchers for this new study pooled together the results of six previously published research studies that compared the effects of antidepressants to placebo for 718 adults with varying levels of depression — from very severe depression, to moderate depression, to mild depression.

Three of the studies looked at paroxetine (Paxil) and the others looked at imipramine (Tofranil). Paxil is an antidepressant known as an SSRI (selective serotonin reuptake inhibitor), while Tofranil is an older medication, known as a tricyclic antidepressant.

The researchers were looking for clinically significant differences in the rating scales used to measure depression, typically of 3 or more points. They found that for mild, moderate and even severe depression, both the sugar pill and the antidepressant were about equally effective. That is, they both helped relieve a person’s depression (suggesting that it’s the act of treating someone — not the drug itself — that is actually helping the person feel better). Only for very severe depression was there a clinically significant difference in rating scale scores for antidepressants.

One of the limitations of the study is obvious — it looked at only two specific antidepressant medications, one of which is not commonly prescribed in the U.S. However, since Paxil is in a class of similar SSRI antidepressants, it would not be unreasonable to suggest that other SSRI antidepressants are likely to suffer from the same issues.

The upshot is simple — doctors and psychiatrists should think twice before prescribing one of these two antidepressants for the vast majority of patients who present with mild to severe depression. This doesn’t mean no treatment is available for such patients — other types of antidepressants are available that weren’t included in this study, and psychotherapy has been shown quite effective in the treatment of mild to moderate depression alone, without any medication.

Will these results hold up in future studies? Time will tell. This is the first study to come to this surprising conclusion and it’s likely more research — and more robust research — is needed before we have the final word on the matter.

Read the full story: Antidepressants Work Better than Placebo for Severe Depression

 


Comments


View Comments / Leave a Comment

This post currently has 12 comments.
You can read the comments or leave your own thoughts.


    Last reviewed: By John M. Grohol, Psy.D. on 6 Jan 2010
    Published on PsychCentral.com. All rights reserved.

APA Reference
Grohol, J. (2010). Placebo as Good as Paxil, Tofranil for Most Depression. Psych Central. Retrieved on April 20, 2014, from http://psychcentral.com/blog/archives/2010/01/06/placebo-as-good-as-paxil-tofranil-for-most-depression/

 

Recent Comments
  • april: I spiralled into a depression and my partner did not understand and could not support me. I could not even...
  • His Back: This is a reasonable article but like many I have read it falls short of a few key points. But first my 11...
  • limbo: Its just so hard to be alone, to be in a tricky situation but there is no one and realising how little I mater...
  • anonymous: Preach to the choir much?
  • Terry: I agree. How about the old “Count your blessings garbage. Or look to the future. What for?
Subscribe to Our Weekly Newsletter


Find a Therapist
Enter ZIP or postal code



Users Online: 12792
Join Us Now!