Why pills may not be the right prescription for easing depression

In 2008, around 36 million prescriptions were given out, an increase of 24 per cent over the previous five years. This dramatic rise has led to concerns that doctors are increasingly supplying the drugs as a "quick fix" without attempting to address the underlying cause of the problems.

Last year, former Lib Dem health spokesman Norman Lamb even went as far as to suggest we had become a "Prozac nation". This could have been dismissed as a headline-grabbing soundbite if it wasn't for the fact that some scientists have genuine concerns about our increasing reliance on antidepressants.

Irving Kirsch, professor of psychology at Hull University, has spent several years studying this issue and has brought together his findings in a new book The Emperor's New Drugs, which has been shortlisted for the Mind Book of the Year award. It is one of seven books that have made it on to the list for the charity award, which celebrates writing

that promotes a greater understanding of mental health issues. Writers Blake Morrison and Fay Weldon are among the judges, with the winner bring announced next month.

Prof Kirsch has written extensively in scientific journals on topics spanning placebo effects, antidepressants and hypnosis, and The Emperor's New Drugs challenges our understanding of antidepressants and how they are used within society. "I wanted to get a comprehensive view of the effect of antidepressants and what that tells us about the nature of depression and its treatment," he says.

"Until now, the belief has been that depression is caused by chemical imbalance and we need drugs to counteract that. But we are at the point now where the chemical balance theory is dead in the water because it has been disproved by the evidence.

"Whether you get a pill that increases, or lowers, serotonin, it doesn't seem to matter because they all produce the same results."

Prof Kirsch says he uncovered previously withheld data taken from clinical trials by drug companies into the pros, cons and effectiveness of antidepressant medication. "We had to use the Freedom of Information Act in order to get access to the data and we found that some of the trials were published but these were usually only the ones that were successful, the rest were hidden from the public."

A couple of years ago, Prof Kirsch led a team of researchers who found that the latest antidepressants had no significant effects on all but the most severely depressed patients in drugs trials. And following his latest research, he concludes that antidepressants are little more effective than placebos.

Pharmaceutical experts have denied this, saying that antidepressants had an effect when treating people with mild to moderate symptoms, and that no medicine would get a licence without demonstrating it was

better than a placebo.

But if the effectiveness of drugs is being questioned then what else

can people turn to? A report in 2008 by the Centre of Complementary Medicine in Germany found St John's Wort can be as good at lifting depression as pharmaceutical drugs.

A review of the research evidence, based on data from 29 studies involving 5,489 patients with mild to moderately severe depression, concluded that the herbal extract was as effective as standard antidepressants but had fewer side-effects.

"There are alternatives that work very well," says Prof Kirsch. One of these is doing more exercise, even going for a walk in the countryside or your local park can make a difference. "We need to do more research but studies carried out so far suggest that it can be as effective as any medication.

"Even better in the short term is cognitive behaviour therapy which has a much better success rate because even if drugs do help some people, most patients end up suffering a relapse."

However, he agrees that those suffering with depression need proper treatment.

"People who are depressed need to be treated because doing nothing isn't the answer, you can't just wish the problem away," he says. "We have been led to believe that antidepressants work better than they actually do and a lot of money has been spent on chemical cures, instead of putting resources into trained therapists who can provide treatment that is more effective and cheaper in the long run."