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An analysis of the medical records of 17.5 million Americans with depression, of whom more than half were taking antidepressants, showed that these drugs did not significantly affect quality of life. how reported in the journal PLOS Onethis indicator turned out to be approximately the same in both people taking medications and people without them.
Depression can negatively impact health-related quality of life—the individual’s own assessment of how much the illness affects for his well-being. In depression, this indicator can to suffer due to unhealthy behaviors: decreased physical activity, overeating, smoking and not taking medication.
Various studies on the effectiveness of antidepressants have shown mixed results. Some of them concluded that most symptom relief (regarding 80 percent) caused placebo effect, then confirmed meta-analyses. Moreover, other studies have shown that psychotherapy has comparable efficacy compared with antidepressants.
The bulk of such studies often take place on a sample of Americans, since from 13 to 16 percent (between 30 and 40 million) of US adults are taking antidepressants, allowing for a large, heterogeneous sample. Despite the clinical data that demonstrate the effectiveness of these drugs in depressive disorder, their impact on the general well-being and quality of life of patients remains controversial.
A group of scientists led by Omar Almohammed from King Saud University decided to test how taking antidepressants affects the quality of life associated with health. This indicator was assessed on two points: the mental component and the physical component of the quality of life. The first component focuses on social functioning, limitations due to emotional problems and mental health. The second is on physical well-being, vitality and limitations due to problems with the health of the body, pain. To evaluate these indicators applied scale, where eight components of the quality of life were evaluated according to 12 parameters.
To do this, they analyzed data from patients with depression from 2005 to 2016. On average, there were 17.47 million adult patients each year who were followed up for at least two years. The mean age of the included adult patients with depression was 48.3 years. About 57.6 percent of patients were treated with antidepressants.
Patients treated with antidepressants were slightly older than patients who did not (49.2 vs 47.1 years, p < 0.0001). Women made up more than two-thirds of the sample (67.9 percent), of whom 60.6 percent received antidepressants, while just over half of the men (51.5 percent) received medication.
Married patients made up the largest proportion of the study sample (47.6 percent), followed by patients who had never been married (23.3 percent); the latter received antidepressants less frequently than others. The majority of patients (62.9 percent) were from middle- and high-income families.
In a simple comparison of data, patients taking antidepressants improved the mental component of quality of life, which did not occur in patients without treatment. The physical component remained unchanged in both groups.
However, univariate analysis showed that both components remained unchanged in both groups (p = 0.9595 for the physical component and p = 0.5284 for the mental component). To adjust for demographic and socioeconomic variables, the researchers conducted a multivariate differential statistical analysis. It included adjustments for age, gender, race, ethnicity, marital status, poverty rate, and insurance.
This analysis confirmed the results of the overall univariate analysis for data from 2005 to 2015, i.e. taking all variables into account, antidepressant use did not improve the physical and mental component compared to patients who did not take antidepressants (p = 0.6405 for the physical component and p = 0 .3191 for the mental component). Thus, the use of antidepressants does not improve the health-related quality of life of patients with depression over time, since the change in this indicator is comparable to patients who did not take antidepressants.
However, it is not worth extending such results to all people who take antidepressants. The sample is limited to purely Americans, and there are datathat up to 72 percent of antidepressant prescriptions in America are given without merit, even without a psychiatric diagnosis. This systemic health issue may significantly affect the validity of antidepressant-related studies conducted in Americans.
From the editor
After publication, the note was supplemented.
And while some scientists understand the quality of life when taking antidepressants, others find other effects. Recently we toldthat scientists studying the response of depressed patients to the expression of pain by others before and following drug treatment found that the ability to empathize with someone else’s pain can be impaired when taking antidepressants.
Glory Gomenyuk