Why Antidepressants Don’t Treat Depression

by Mark Hyman, M.D. | July 7th, 2010 | Comments (11)
topic: Health & Wellness

Here’s some depressing recent medical news: Antidepressants don’t work. What’s even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they DO work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.

A study published in The New England Journal of Medicine found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit — but almost none of the studies that show these drugs are ineffective.

That warps our view of antidepressants, leading us to think that they do work. It has fueled the tremendous growth in the use of psychiatric medications, which are now the second leading class of drugs sold, after cholesterol-lowering drugs.

The problem is even worse than it sounds because the positive studies hardly showed benefit in the first place. For example, 40 percent of people taking a placebo (sugar pill) got better, while only 60 percent taking the actual drug had improvement in their symptoms. Looking at it another way, 80 percent of people get better with just a placebo.

That leaves us with a big problem. However, there are treatments available. Functional medicine provides a unique and effective way to treat depression and other psychological problems. I will review seven steps you can take to work through your depression without drugs. But before we get to that, let’s take a closer look at depression.

What’s in a name?

Depression is a label we give to people who have a depressed mood most of the time, have lost interest or pleasure in most activities, are fatigued, can’t sleep, have no interest in sex, feel hopeless and helpless, can’t think clearly or can’t make decisions.

But that label tells us NOTHING about the cause of those symptoms. There are dozens of causes of depression — each one needing a different approach to treatment. Depression is not one-size-fits-all, but it is very common.

Women have a 10 to 25 percent risk and men a 5 to 12 percent risk of developing severe major depression in their lifetime. One in 10 Americans takes an antidepressant. The use of these drugs has tripled in the last decade, according to a report by the federal government. In 2006, spending on antidepressants soared by 130 percent.

Just because antidepressants are popular doesn’t mean they’re helpful. Unfortunately, as we now see from this report in The New England Journal of Medicine, they don’t work and have significant side effects. Most patients taking antidepressants either don’t respond or have only partial response. In fact, success is considered just a 50 percent improvement in half of depressive symptoms. This minimal result is achieved in less than half the patients taking antidepressants. It’s only made worse by the fact that 86 percent of people taking antidepressants have one or more side effects, including sexual dysfunction, fatigue, insomnia, loss of mental abilities, nausea and weight gain.

No wonder half the people who try antidepressants quit after four months.

I want to talk to you about the reasons why doctors and patients have been deceived by the “antidepressant hoax.” Despite what we have been brainwashed to believe, depression is not a Prozac deficiency!

How we have been deceived by the antidepressant hoax

Drug companies are not forced to publish all the results of their studies. They only publish those they want to. The researchers who reported their findings in The New England Journal of Medicine took a critical look at all the studies done on antidepressants, both published and unpublished. They dug up some serious dirt …

The unpublished studies were not easy to find. The researchers had to search the FDA databases, call researchers, and hunt down hidden data under the Freedom of Information Act. What they found was stunning.

After looking at 74 studies involving 12 drugs and over 12,000 people, they discovered that 37 of 38 trials with positive results were published, while only 14 of 36 negative studies were published. Those that showed negative results were, in the words of the researchers, “published in a way that conveyed a positive outcome.”

That means the results were twisted to imply the drugs worked when they didn’t.

This isn’t just a problem with antidepressants. It’s a problem with scientific research. Some drug companies even pay or threaten scientists to not publish negative results on their drugs. So much for “evidence-based” medicine!

Most of the time, we only have the evidence that the drug companies want us to have. Both doctors and patients are deceived into putting billions of dollars into drug companies’ pockets, while leaving millions with the same health problems, but less money.

What can we do? Unfortunately, there is no easy answer. But I do think functional medicine, on which my approach of UltraWellness is based, provides a more intelligent way of understanding the research. Rather than using drugs to suppress symptoms, functional medicine helps us find the true causes of problems, including depression.

I see this in so many of the patients I have treated over the years. Just as the same things that make us sick also make us fat, the same things that make us sick also make us depressed. Fix the causes of sickness — and the depression takes care of itself.

7 steps to treat depression without drugs

1. Try an anti-inflammatory elimination diet that gets rid of common food allergens. Food allergies and the resultant inflammation have been connected with depression and other mood disorders.
2. Check for hypothyroidism. This unrecognized epidemic is a leading cause of depression. Make sure to a have thorough thyroid exam if you are depressed.
3. Take vitamin D. Deficiency in this essential vitamin can lead to depression. Supplement with at least 2,000 to 5,000 IU of vitamin D3 a day.
4. Take omega-3 fats. Your brain is made of up this fat, and deficiency can lead to a host of problems. Supplement with 1,000 to 2,000 mg of purified fish oil a day.
5. Take adequate B12 (1,000 micrograms, or mcg, a day), B6 (25 mg) and folic acid (800 mcg). These vitamins are critical for metabolizing homocysteine, which can play a factor in depression.
6. Get checked for mercury. Heavy metal toxicity has been correlated with depression and other mood and neurological problems.
7. Exercise vigorously five times a week for 30 minutes. This increases levels of BDNF, a natural antidepressant in your brain.

Overcoming depression is an important step toward lifelong vibrant health. These are just of few of the easiest and most effective things you can do to treat depression. But there are even more, which you can address by simply working through the 7 Keys to UltraWellness.

To your good health,

Mark Hyman, M.D.

Another study purports to find that, for most people, Prozac and the other members of the antidepressant family of pharmaceuticals are no better than sugar pills. Expect Big Pharma to object, but not too loudly. At least, don’t expect them to expend too much effort and money denouncing the findings. We’ve heard this before, and it would seem that neither patients nor the doctors that prescribe antidepressants care much about whether or not the drugs actually do what their makers claim they do.