Use of antidepressants on a long-term basis is not associated with significantly better health-related quality of life, an analysis of a large US database has suggested.
Researchers looking at patients diagnosed with depression between 2005 and 2016 found no statistical difference in health-related quality of life scores in those who took antidepressants compared with those who were not prescribed medication after two years of follow up.
The analysis, which looked at results of the SF-12 self-reported health outcomes survey, found some improvement in the mental components of the questionnaire over time in those who were prescribed antidepressants.
But a careful comparison showed no significant difference in health-related quality of life in terms of mental or physical health between the group taking antidepressants and those who had been diagnosed with depression but were not prescribed medication.
The study, which used data from the US Medical Expenditures Panel Survey, also showed that more women than men were diagnosed with depression, the researchers reported in PLoS ONE.
Over the course of the study, an average of 17.5 million adults were diagnosed with depression each year in the United States, with around 58% receiving antidepressants.
“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 researchers, based at King Saud University in Saudi Arabia, concluded.
“With that being said, the role of cognitive and behavioural interventions on the long term-management of depression needs to be further evaluated in an effort to improve the ultimate goal of care for these patients; improving their overall quality of life.”
A UK-based randomised controlled trial published in 2021 found that people who stop taking antidepressants after two years or more are more likely to experience a relapse of depression within one year, compared with those who continue taking their medication.
Professor David Taylor, director of pharmacy and pathology at the Maudsley Hospital and professor of psychopharmacology at King’s College London, said: “Antidepressants are effective in the short time and provide some protection against relapse. This study suggests that antidepressants do not improve quality of life to any greater extent than non-drug treatment and that, overall, improvement is marginal.
“Two possible reasons lie behind this finding: poor adherence to prescribed antidepressants and continued prescribing of ineffective antidepressants to individuals with depression.”
He added: “Both are very common in practice. We need better antidepressants, but before that we need to use antidepressants better.”