Comparing 21 commonly used antidepressants, the United Kingdom study concludes that all are more effective than placebo for the short-term treatment of acute depression in adults, with effectiveness ranging from small to moderate for different drugs.
An estimated 350 million people have depression worldwide.
Researchers at the University of Oxford wanted to clear up lingering questions about how effective medicine is in treating acute depression in adults.
Andrea Cipriani, from Oxford's Department of Psychiatry, said: 'Under-treated depression is a huge problem and we need to be aware of that. Fluvoxamine, reboxetine, and trazodone, were also among the least effective, while on the other hand, amitriptyline, mirtazapine, and venlafaxine were the best-performing drugs.
"Our study brings together the best available evidence to inform and guide doctors and patients in their treatment decisions", she said in a statement. And, though the meta-analysis is strong, this paper is unlikely to conclusively end the debate over the efficacy of antidepressants.
A review of 522 trials published between 1979 and 2016, covering 116,477 patients total, found that common antidepressants really do work. Pharmaceutical companies have very little incentive to publish trials with negative results, and journals also nearly never publish negative results, so published results are skewed towards positivity. Some patients simply do not want to take pills for a mental health condition. It was carried out by a team of worldwide experts.
The global study uncovered a range of outcomes, with some drugs proving more effective than others and some having fewer side effects.
In general, newer antidepressants tended to be better tolerated due to fewer side effects, while the most effective drug in terms of reducing depressive symptoms was amitriptyline - a drug first discovered in the 1950s.
But some do the job better than others.
In a commentary in the journal, Sagar Parikh from the University of MI in the U.S. and Sidney Kennedy from the University of Toronto in Canada pointed out that three drugs scored best for efficacy and tolerability: agomelatine, escitalopram, and vortioxetine. But fluoxetine (prozac) makes me functional and effective, and gives me back my life force.
No permanent CM in my party, says Kamal Haasan
He stated in Rameswaram that people should no longer see him as a film star but a lamp that belongs to the people's houses. Kamal describes his political journey as a journey of discovery, a journey to understand people's needs and aspirations.
New Zealand cleans up after Cyclone Gita devastation
The state of emergency in Buller, Grey and Westland districts had been lifted on Wednesday morning but remained in placed for Nelson.
Missouri Governor Eric Greitens charged over nude photo
Image copyright Missouri Governor's Office Image caption A lawyer for the governor says the allegations are politically motivated. Eric Greitens on Thursday, putting him in legal peril and begging the question of whether he can survive the political fallout.
It has been suggested that more than a million people per year in the United Kingdom should be given access to treatment for depression, through either drugs or talking therapies, with scientists saying the study proves that the drugs do work.
But Cipriani said any of the drugs might still have their uses.
The study's authors said the findings could help doctors to pick the right prescription, but it did not mean everyone should be switching medications.
To the millions of people who benefit from antidepressants, these results may seem obvious.
New treatments are badly needed, the experts say. "We don't have any very precise treatments for depression at this point in time", said Geddes.
Most of the 522 studies that the team analyzed were funded by pharmaceutical companies and thus carried a risk of bias.
The study, published in The Lancet medical journal, found some differences in the effectiveness of the 21 drugs.
James Warner, an Imperial College London psychiatrist, added: "Depression causes misery to countless thousands every year and this study adds to the existing evidence that effective treatments are available".
"Ultimately, the field requires different research strategies to identify response at the level of the individual patient, not just network meta-analysis with larger sample sizes. It should never be swept under the carpet or ignored".