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Antidepressant works ‘by reducing anxiety symptoms first’

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A commonly-prescribed antidepressant reduces anxiety first and has a smaller impact on depressive symptoms weeks later, a research suggests.

Researchers at University College London mentioned it made individuals really feel higher however labored in surprising methods.

Their trial concerned 653 UK sufferers, half of whom got sertraline and the opposite half a placebo (dummy tablet).

Psychiatrists say the findings are reassuring for medical doctors and sufferers, confirming the advantages of therapy.

Antidepressants are one of the vital commonly-prescribed drugs within the UK and issues have typically been raised that too many are being given to sufferers.

Sertraline, a selective serotonin reuptake inhibitor (SSRI), is among the commonest medicine used to deal with symptoms of despair and anxiety.

But scientists nonetheless have little concept of how these form of medicine work.

Quick enhancements

In this research, printed in The Lancet Psychiatry journal, sufferers with delicate to extreme depressive symptoms, or anxiety, or a mixture of each, had been chosen from 179 GP surgical procedures within the UK and enrolled on the trial.

In all circumstances, GPs weren’t certain whether or not to prescribe an antidepressant.

After six weeks, the sufferers taking sertraline reported a 21% higher enchancment in anxiety symptoms – resembling feeling frightened, nervous and irritable – in comparison with the management group taking a dummy tablet. After 12 weeks, the hole was 23%.

But there was little proof of the drug reducing depressive symptoms, resembling poor focus, low temper and lack of enjoyment after six weeks – and solely marginal enhancements (13%) after 12 weeks.

Nonetheless, the group taking antidepressants had been twice as seemingly as the opposite trial contributors to say their psychological well being felt higher total.

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“It appears that people taking the drug are feeling less anxious, so they feel better overall, even if their depressive symptoms were less affected,” mentioned lead research writer Dr Gemma Lewis, from UCL.

She mentioned the findings counsel sertraline and comparable antidepressants are getting used appropriately by GPs – and extra sufferers with delicate to average symptoms may gain advantage from them.

Unexpected discovering

Prof Glyn Lewis, additionally a part of the research, mentioned he was shocked by the outcomes of the trial.

“They [antidepressants] work, just in a different way than we had expected,” he mentioned.

“We definitely need better treatments for depression, and more research, but they are effective drugs.”

The research discovered there was additionally little proof of side-effects within the group taking sertraline.

Antidepressants resembling sertraline work by rising ranges of serotonin within the mind.

Dr Sameer Jauhar, honorary marketing consultant psychiatrist from King’s College London, mentioned the trial’s optimistic findings in all probability mirrored why GPs prescribe antidepressants.

But he mentioned they weren’t related to individuals with main despair.

“It is not surprising that depressive symptoms did not improve to a great extent, given that only half the people had a diagnosis of depression.”

‘Not for everybody’

Prof Wendy Burn, president of the Royal College of Psychiatrists, mentioned the findings can be “reassuring for both doctors and patients”.

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But she added: “It also shows that antidepressants are not the solution for everyone and reinforces the importance of combining them with other options, such as talking therapies and social prescribing.”

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, mentioned antidepressants labored greatest “when taken for significant periods of time, which is one reason why doctors will often review patients after several weeks of use and then prescribe a fairly long course of the drugs, if they appear to be beneficial”.

“This study gives an interesting insight into how a medication primarily used to treat depression may be improving a patients’ health in other ways in the shorter term, by reducing symptoms of anxiety, which is often associated with depression.”

Previous analysis discovered that all antidepressants had been more practical at reducing symptoms of acute despair than dummy drugs, nevertheless it was not primarily based on sufferers’ particular person views of how they felt.

The trial is the biggest placebo-controlled trial of an antidepressant which has not been funded by the pharmaceutical business, the UCL researchers mentioned.

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