The drugs don’t work

I once saw my friend Stuart banging his head on the floor, weeping, threatening to kill himself. He was severely depressed, incapable of working, sleeping or eating. Yet within three weeks of being prescribed a course of a Prozac-type antidepressant drug, he was beginning to cope again and was back at work. As he got better he made this shocking remark: “If I was offered a choice between cancer and depression, I’d take the cancer.”

Stuart swears by his antidepressant medication, which he took for two years. “It saved my life,” he says. But the effectiveness of such drugs, known as SSRIs (of which more later), has been challenged for two decades. The latest anti-antidepressant blast is one of the most meticulously researched. In The Emperor’s New Drugs (Bodley Head) Irving Kirsch, a professor of psychology at the University of Hull, claims that SSRIs are worse than useless.

Depression is a devastating illness, causing great suffering in the afflicted and anxiety to their nearest and dearest: it can hit at any age. One in three of us will suffer a form of depression, from mild to severe, at some time in our lives. According to the EU’s public health committee, it is set to become the single most frequently suffered illness in Europe by 2020.

Before the advent of Prozac-type drugs, Stuart would have been hospitalised as a danger to himself, perhaps given electro-convulsive therapy, dosed with barbiturates or a crude sedative medication. Those were the bad old days of huge county asylums, when 50 per cent of NHS hospital beds were taken up by the mentally ill. By the 1970s, these institutions were being closed down, made possible by new types of drugs and the provision of talk therapies such as cognitive behavioural therapy (CBT). While patients suffering acute psychotic illnesses are still hospitalised in the psychiatric wings of general hospitals, depressed patients are usually treated as outpatients. So who could doubt the benefits of a class of well-tried antidepressants, which have been dispensed for two decades and account for 20m prescriptions a year in Britain? Their claimed success rate, based on clinical trials and practitioner reporting, is 70 per cent.

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