The Effectiveness of Antidepressants Today
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In this chapter we discuss tricyclic antidepressants, which were initially used with remarkable success on the limited number of patients suffering from serious endogenous depression. The therapeutic action obtained was accompanied by considerable side effects . This encouraged the search for effective antidepressants that would be better tolerated by the patients, leading to the use of selective serotonin reuptake inhibitors These compounds rapidly encountered the favour of psychiatrists, and Prozac , the progenitor of this class, was prescribed between 1987 and 2002 to 40 million Americans with sales of 22 billion dollars. Subsequent serious investigations revealed that the clinical trials given to the regulatory agencies used unreal and irrelevant criteria of effectiveness; in the real world, few patients responded to the treatment at all, and for mild depression the response was equal to that of a placebo
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