The use of antidepressants is not linked to a significantly better health-related quality of life in the long run, according to a large new study published in the journal PLOS ONE.
It’s known that depression can have a notable impact on “health-related quality of life,” a multi-faceted concept that looks at a person’s physical, mental, emotional, and social function to understand their ability to live a fulfilling life.
While some people find antidepressants can be effective at treating or easing the mental condition itself, this latest study found that the medications might not significantly benefit the patients’ wider well-being in the long term.
To reach these conclusions, scientists at King Saud University in Saudi Arabia looked at data from a huge longitudinal study that tracked the use of health services by people in the US from 2005 to 2015, encompassing over 17 million adult patients diagnosed with depression each year during the study duration.
Just over 57 percent of those diagnosed with depression in the data bank received treatment with medication, primarily second-generation antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). After accounting for other factors that may have been influencing the outcome, the team looked at how the patients' health-related quality of life fared after two years.
They concluded that the change in the quality of life seen among those taking antidepressants for over two years was not significantly different from that seen among depressed people not taking the drugs.
This doesn’t mean that antidepressants don’t work — multiple previous studies have found antidepressants can be a valuable tool for treating depression in some people — but these findings hint that their ability to improve wider quality of life in the longer term may be limited.
There are some limitations to consider when looking at this study, however. For one, the researchers didn’t separately analyze different subtypes or varying severities of depression. Secondly, it also didn’t break down the effectiveness of different types of antidepressants, of which there are a few different classes that work in different ways.
Depression is an incredibly common condition. It affects about 16 million people in the US every year, with around one out of every six adults experiencing depression at some time in their life, according to the US Centers for Disease Control and Prevention.
Nevertheless, the discussion around antidepressants to treat depression is far from straightforward. While many clinicians and patients look favorably on antidepressants, certain reviews have found they hold “minimal” and possibly zero benefits for the average patient with major depressive disorder.
Another concern is that antidepressants have become too overly prescribed in certain parts of the world. In 2005, antidepressants became the most widely prescribed drugs in primary care and in-hospital outpatient clinics across the US, with rates of use doubling between 1996 and 2005.
This latest study is not going to settle any of these long-standing debates, but the researchers are interested to build on their paper and see whether the impact of antidepressants can be affected when used in combination with other non-pharmacological treatments, like counseling and behavioral therapy.
“Although we still need our patients with depression to continue using their antidepressant medications, long-term studies evaluating the actual impact for pharmacological and non-pharmacological interventions on these patients’ quality of life is needed,” the study authors write.
“With that being said, the role of cognitive and behavioral interventions on the long term-management of depression needs to be further evaluated in an efforts to improve the ultimate goal of care for these patients; improving their overall quality of life.”