Treatment of light-to-moderate depression by talk therapy, medications and complementary medicine techniques is no more effective than a placebo, according to a meta-analysis of 177 studies that included a senior psychiatrist at Jerusalem’s Herzog Hospital.
Prof. Pessah Lichtenberg, head of the men's psychiatry department at Herzog Hospital, and colleagues around the world published their findings in the latest issue of PLoS One (Public Library of Science).
Lichtenberg will deliver a lecture on the subject at the international Beyond the Placebo conference in Zurich next week.
None of the conventional or complementary techniques singly proved more effective in alleviating mild to moderate depression than a harmless sugar pill, Lichtenberg wrote.
There was a small advantage to antidepressants in combination with psychotherapy, he said.
“These findings are important, but they weren’t a complete surprise,” said Lichtenberg, the only Israeli to participate in the meta-analysis, which included data on 25,000 patients.
“In recent years, there have been several studies on the subject with results in the same direction. But this research is unique due to the broad variety of types of treatment that were examined,” he said.
Dozens of treatment techniques including dynamic psychotherapy, antidepressants, cognitive behavioral therapy, relaxation, exercise and acupuncture were examined.
However, when patients suffered from serious depression, the medications had a clear advantage over a placebo.
The conditions of patients who did not receive any treatment and were put on a waiting list did not improve at all, Lichtenberg said.
“The message is that when there is depression, it should be treated, but how it should be treated is less clear. There is no doubt that the use of antidepressants is very common in Israel and around the world, and they are prescribed too easily even though other techniques with fewer side effects could be just as effective,” he said.
The study was initiated by Prof. Arif Khan, a board-certified psychiatrist at the Duke University School of Medicine and the medical director of the Northwest Clinical Research Center in Bellevue, Washington.
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