Antidepressants rank third in the most prescribed drugs worldwide and fourth among the best-selling drugs. However, their security remains as a controversial issue. Now, international research showed that these drugs are, in general, safe.
Researchers from several international institutions in Europe, the United States, Canada and Asia have globally evaluated the results of several meta-analyses on antidepressant effects without finding any solid evidence of negative health effects associated with their use.
This study, published in JAMA Psychiatry, is the first to date that evaluates the safety of these drugs on such a large scale. “This is, without a doubt, the most conclusive work regarding the long-term safety of antidepressants. It shows that well used [antidepressants] have many more benefits than risks.” explains spanish scientist Eduard Vieta, director of CIBERSAM (Center for Research in Mental Health), who participated in the study.
To make this analysis, the researchers systematically evaluated the evidence of more than a thousand observational studies included in 45 meta-analyzes reviewed, covering different age groups, underlying psychiatric ailments and possible adverse effects.
“We found that all adverse events, or side effects, that have been described in observational studies were highly likely due to the patient’s conditions, but not because of the antidepressants themselves,” said Vieta, head of the Psychiatry and Psychology Department at Hospital Clinic, Professor at the University of Barcelona and head of the Research Team in Bipolar Disorder at IDIBAPS.
The findings suggest that most of the alleged adverse health outcomes associated with the use of antidepressants may not be supported by convincing evidence, and confusion by indication could ‘alter’ the few associations that were detected with ‘convincing’ evidence. That is, it is likely that the adverse effects reported in the studies are due to the condition that motivated the prescription of the antidepressant, rather than the antidepressant itself.
The results of this general review are important in the context of the increased use of antidepressants worldwide. Currently, it is estimated that between 8 and 10% of Americans take at least one antidepressant. They are usually prescribed for depression, anxiety, posttraumatic stress, obsessive-compulsive disorder and eating disorders, among others.
Evangelos Evangelou, an epidemiologist at the University of Ioannina (Greece) and the Imperial College of the United Kingdom, and lead author of the study, considers that, “although we have shown that antidepressants are safe, we must take into account that the adverse effects must be controlled clinically during treatment.” Finally, the authors point out that it was not possible to evaluate some newer types of antidepressants due to the limited information available so far.