“Antidepressants work for depression.”
Antidepressants relieve major depression better than a placebo pill, but the average extra benefit is modest and some people gain much more than others.
Antidepressants are a proven treatment for depression, though not a guaranteed one: some people feel much better, others notice only a small change. The extra benefit tends to be larger when depression is more severe, and the best choice depends on your symptoms, side effects, preferences and options such as therapy.
If depression is affecting your life, discuss therapy, medication or both with a qualified clinician instead of ruling medication in or out based on one headline.
Safety note: Do not stop or change a prescribed antidepressant without a plan with your prescriber. Some people under 25 have increased suicidal thoughts or behavior early in treatment or after a dose change, so watch for worsening symptoms at any age, especially in the first weeks.
Talk to a healthcare professional if: you have side effects, or want to change your dose or stop your medicine. Get help right away for new thoughts of suicide or symptoms that get worse quickly, and call emergency services if there is immediate danger.
Hundreds of double-blind trials with more than 100,000 adults show that antidepressants beat placebo for major depression, which is why confidence is strong. The verdict is Mostly true rather than True because the average extra benefit over a placebo pill is modest, and a large drug-specific benefit shows up in only a minority of people.
Antidepressants relieve major depression better than a placebo pill, but the average extra benefit is modest and some people gain much more than others. In 522 trials with more than 116,000 adults, all 21 antidepressants studied beat placebo. In FDA data from 232 trials, about 25% of people on a drug had a large improvement versus about 10% on placebo, while the average extra gain was 1.75 points on a standard depression rating scale.
Many people in depression trials improve on a placebo too, so the drug's own effect is the difference between the two groups. In the FDA data, that difference was larger in people whose depression was more severe at the start. Drugs differed in how well they worked and how many people stopped taking them, and these trials looked at short-term treatment of adults, not long-term use or children.
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- Stone MB, Yaseen ZS, Miller BJ, Richardville K, Kalaria SN, Kirsch I. Response to acute monotherapy for major depressive disorder in randomized, placebo controlled trials submitted to the US Food and Drug Administration: individual participant data analysis. BMJ. 2022;378:e067606. DOI: 10.1136/bmj-2021-067606. PMID: 35918097. PMCID: PMC9344377
- NIH National Institute of Mental Health. Mental Health Medications. Last reviewed December 2023