The question of whether antidepressants work is a complicated one.

I think if you spoke to doctors or specialists who prescribe Prozac and Seroxat, many would acknowledge that these treatments have benefited patients suffering from depression.

You'd get similar answers if you spoke to people who have taken them.

But is the benefit due to the drug itself or is it down to a placebo effect, the effect that comes from simply believing something will do you good?

Even according to this new study from Hull University, that depends.

Firstly, it depends on how severe your depression is. If it's mild, SSRIs (selective serotonin reuptake inhibitors) such as Prozac and Seroxat aren't the treatment of choice. And it should come as no surprise there could be a placebo effect at work.

We've known for a long time that "talking therapies", where you share your problems, exercise (30 minutes walking in fresh air cuts depression by 70 per cent) - and CBT (cognitive behavioural therapy), which changes the way you think, all help.

Then again, it depends on whether you're suffering from true depression or mainly anxiety. SSRIs don't work for anxiety and if your doctor doesn't make the distinction your misdiagnosed depression won't get better.

The use of a standardised mental health questionnaire (HAD for short) by doctors prior to writing a prescription for an SSRI would help target people whom the drugs would really help. Using the HAD scale would also give the doctor a score indicating how serious the depression is. Patients with mild to moderate depression are best advised to avoid prescription drugs.

The mixed evidence for SSRIs may have yet another explanation - it could be your genes that decide whether or not your depression gets better on an SSRI. US research points to genetic variations, which may determine why a drug has a good effect on you but not on someone else. You could be genetically receptive to an SSRI for your depression, but someone else with different genes may not be.

In a clinical study the inclusion of patients who are resistant to SSRIs could mask the beneficial effect on patients who respond to the drug. This would account, in part, for the difficulty in proving the antidepressant is better than placebo.

Should you be concerned about taking SSRIs? There's no question they have fewer side-effects than older antidepressants - but there is evidence they can encourage suicidal thoughts in young people.

Kicking the habit without getting the blues

"Thirty one million antidepressant prescriptions were written in the UK by GPs in 2006," says Emma Smith, spokeswoman for the mental health charity SANE.

"If you're taking any type of antidepressant, especially Prozac, the worst thing is to stop taking it suddenly, because you can have serious withdrawal symptoms."

Pam Armstrong, co-founder of CITA, a charity for people who've become addicted to prescription drugs, adds:

"Withdrawal symptoms could include low mood, anxiety, insomnia, nausea and stomach pains and headaches.

"Normally withdrawal will kick in within a day. Sometimes people on Prozac think they're okay when they stop, but the withdrawals will come if you stop suddenly.

"I've helped people who've had seizures and hallucinations, such as seeing spiders running up the wall.

"These are powerful drugs, if you suddenly stop your medication you're putting yourself in great danger. People go into a trance-like state, behave out of character, and in some cases harm themselves and others.

"It's much safer to come off prescription drugs gradually and with If you're concerned about taking antidepressants yourself, see a GP or ring CITA. We help 100s of people come off prescription drug every year, and of these 800 are on antidepressants as Prozac."

Healthy alternatives.. walking and talking

Pam Armstrong, of CITA, says: "The Hull report highlights what we as a charity already know - antidepressants only work in a small number of cases.

"We believe they should only be prescribed for people with severe depression and whenever possible, other therapies should be used such as counselling and psychotherapy."

Talk to a friend or family member who understands you about your feelings.

Talking therapies, such as CBT (cognitive behaviour therapy), will teach you to replace negative thoughts and feelings with positive ones.

Read Foods That Harm Foods That Heal (Reader's Digest, £8.99).

Exercise to release feel good endorphins, the body's natural pick-me-up.

Get out into the fresh air. Research at the University of Essex found a 30-minute walk cut depression in more than 70 percent of people.

St John's Wort is said to be a safe and effective way to treat mild to moderate depression. Dosage should be directed by a qualified practitioner. Go to www.associationofmasterherbalists.co.uk

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