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Antidepressants Less Effective for Mild, Moderate Symptoms

Meta-analysis shows clinical effectiveness only in patients with high depression scores

TUESDAY, Jan. 5 (HealthDay News) -- Although antidepressant medications are effective for patients with severe depression, they have minimal, or even no, effect on patients with mild or moderate depressive symptoms, according to a study in the Jan. 6 issue of the Journal of the American Medical Association.

Jay C. Fournier, of the University of Pennsylvania in Philadelphia, and colleagues conducted a patient-level meta-analysis of six studies involving 718 adult outpatients who received either an antidepressant medication or placebo for at least six weeks.

Compared to placebo, the researchers found that medication was associated with a substantial effect in patients with a Hamilton Depression Rating Scale score of 25 or above; however, they found that medication was associated with only a small effect in patients with scores below 23.

"Prescribers, policy makers, and consumers may not be aware that the efficacy of medications largely has been established on the basis of studies that have included only those individuals with more severe forms of depression," the authors write. "This important feature of the evidence base is not reflected in the implicit messages present in the marketing of these medications to clinicians and the public. There is little mention of the fact that efficacy data often come from studies that exclude precisely those major depressive disorder patients who derive little specific pharmacological benefit from taking medications."

Several authors reported financial relationships with pharmaceutical companies.

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