Although antidepressants are prescribed with increasing frequency, their efficacy is the subject of debate. It’s known that placebos can be just as effective in cases of mild-to-moderate depression. Nevertheless, in Germany you’re now eight times more likely to be prescribed the medication than in the 1990s.

A large-scale study from 2008 shows that in cases of mild and moderate depression, a placebo was just as effective as the real thing. But still, every year doctors prescribe enough antidepressants to supply 80 million people in Germany for more than two weeks.

So, what’s the impact on patients? How can such controversial medication be so successful?

"For many years, the tablets have been my loyal companions in the process of coping with my depression." Christine (52) lost her job because of her depression, attended psychiatric clinics seven times and says today: "I don’t care what the studies say, I sense that my medication is working."

Most antidepressants alter the levels of certain neurotransmitters in the brain, in particular serotonin. Although for a long time it was thought depression was triggered by lowered serotonin concentration, this theory has now been disproved. Doctors and scientists still don’t really understand what happens in the brain during depression - but this has done nothing to dent the successful sales march of antidepressant medication.

Mary (42) curses the day she began taking antidepressants: "They haven’t improved my life, they’ve actually made it much worse," she says. Mary’s been gradually reducing her dose for four years, but her body is rebelling. "Up to now, these weaning problems have been totally under-estimated," says Professor Tom Bschor, one of the leading experts on antidepressants in Germany.

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