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Sertraline: Antidepressant works 'by reducing anxiety symptoms first' before depression

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Importantly, and I guess what we always say on here the article quotes a Dr.  "It also shows that antidepressants are not the solution for everyone and reinforces the importance of combining them with other options, such as talking therapies and social prescribing."



A commonly-prescribed antidepressant reduces anxiety first and has a smaller effect on depressive symptoms weeks later, a study suggests. Researchers at University College London said it made people feel better but worked in unexpected ways.

Their trial involved 653 UK patients, half of whom were given sertraline and the other half a placebo (dummy pill). Psychiatrists say the findings are reassuring for doctors and patients, confirming the benefits of treatment.

Antidepressants are one of the most commonly-prescribed medications in the UK and concerns have often been raised that too many are being given to patients. Sertraline, a selective serotonin reuptake inhibitor (SSRI), is one of the most common drugs used to treat symptoms of depression and anxiety.

But scientists still have little idea of how these kind of drugs work.

In this study, published in The Lancet Psychiatry journal, patients with mild to severe depressive symptoms, or anxiety, or a mix of both, were selected from 179 GP surgeries in the UK and enrolled on the trial. In all cases, GPs were not sure whether to prescribe an antidepressant.

After six weeks, the patients taking sertraline reported a 21% greater improvement in anxiety symptoms - such as feeling worried, nervous and irritable - compared to the control group taking a dummy pill. After 12 weeks, the gap was 23%.

But there was little evidence of the drug reducing depressive symptoms, such as poor concentration, low mood and lack of enjoyment after six weeks - and only marginal improvements (13%) after 12 weeks.

Nonetheless, the group taking antidepressants were twice as likely as the other trial participants to say their mental health felt better overall.

"It appears that people taking the drug are feeling less anxious, so they feel better overall, even if their depressive symptoms were less affected," said lead study author Dr Gemma Lewis, from UCL.  She said the findings suggest sertraline and similar antidepressants are being used correctly by GPs - and more patients with mild to moderate symptoms could benefit from them.

Prof Glyn Lewis, also part of the study, said he was surprised by the results of the trial. "They [antidepressants] work, just in a different way than we had expected," he said.  "We definitely need better treatments for depression, and more research, but they are effective drugs."

The study found there was also little evidence of side-effects in the group taking sertraline. Antidepressants such as sertraline work by increasing levels of serotonin in the brain.   

Dr Sameer Jauhar, honorary consultant psychiatrist from King's College London, said the trial's positive findings probably reflected why GPs prescribe antidepressants. But he said they were not relevant to people with major depression. "It is not surprising that depressive symptoms did not improve to a great extent, given that only half the people had a diagnosis of depression."

Prof Wendy Burn, president of the Royal College of Psychiatrists, said the findings would be "reassuring for both doctors and patients".  But she added: "It also shows that antidepressants are not the solution for everyone and reinforces the importance of combining them with other options, such as talking therapies and social prescribing."

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said antidepressants worked best "when taken for significant periods of time, which is one reason why doctors will often review patients after several weeks of use and then prescribe a fairly long course of the drugs, if they appear to be beneficial".

"This study gives an interesting insight into how a medication primarily used to treat depression may be improving a patients' health in other ways in the shorter term, by reducing symptoms of anxiety, which is often associated with depression."

Previous research found that all antidepressants were more effective at reducing symptoms of acute depression than dummy pills, but it was not based on patients' individual views of how they felt.

The trial is the largest placebo-controlled trial of an antidepressant which has not been funded by the pharmaceutical industry, the UCL researchers said.



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It's an interesting article. I can't believe that it's the largest trial not funded by a pharmaceutical company and yet these drugs have been available for years! 

It was good to see that there were little side effects, because from what I can remember there were questions placed on the last major trial because of side effects. If you test against placebo then often side effects give away that you're on the active medication, therefore making it no longer blind and open to bias. 

Still no research showing they work long term, which I think is always the problem, because all you get is the headline 'antidepressants work', without the caveat that beyond a certain amount of time, they just don't know.

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I am not in favour of wacking out the drugs to sufferers like us just like that. 

I would like to see more awareness among doctors of the help that charities such as ours can give in embracing CBT therapy through other means whilst on a waiting list for one to one CBT. 

For me, throwing the pills at people shouldn't be standard. 

Why may not the doctors encourage us towards self-help and charitable guidance instead? 


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Based on the above press release... what do you all think about these comments?  (Not written by me).



Following breaking reports that a study published in the Lancet Psychiatry has found that the most commonly prescribed antidepressant barely relieves symptoms of modern depression, it is now more apparent than ever that the UK's mental health really is in dire straits. 

Roughly 7.3 million people in England are issued a prescription of antidepressants each year, but an independent investigation has revealed that patients taking sertraline, the most common antidepressant prescribed in the UK, experienced next to no improvements in mood.

"The state of the UK's mental health is something we must address. The rates of people reporting mental health problems are rising rapidly, and the news that millions of people who take antidepressants have been doing so essentially in vain is extremely disheartening, not to mention alarming. Not only this, but our research has found that millions of people are suffering with mental health problems without any help, because they are aware of the potential side effects and addiction concerns surrounding prescription drugs. It is of paramount importance that we examine and explore other methods of mental health treatment, especially those that are non-invasive with no potential for addiction



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You're warm... from the UK but yes a TMS company who sent it as a press release to a journalist (who happens  to know me).  Three guesses which  TMS company.

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