The Truth About Antidepressants
A controversial new study suggests the widely prescribed antidepressants
Prozac,
Paxil, and
Effexor work no better than placebo for most patients who take them, and
many depression experts now cry foul.
What does the new study say about the ineffectiveness of antidepressants?
In findings published in the February issue of the journal PloS
Medicine, researchers conclude that when taken as a whole, the data show
that only a small group of the most severely depressed patients benefit from
taking one of the antidepressants.
For less severely depressed patients, the antidepressants were found to work
no better than placebos, leading the researchers to conclude that most patients
who take antidepressants probably shouldn’t be on them.
Does this study contradict numerous positive studies on antidepressants?
Yes, it does. In a statement, American Psychiatric Association
President-elect Nada Stotland, MD, maintains that studies like this one, which
compare a single drug to placebo, do not accurately reflect the way doctors
prescribe antidepressants today.
Stotland says many people who are depressed do not respond to the first
antidepressant they try. “It may take up to an average of three or more
different antidepressants until we find the one that works for a particular
individual. Therefore, testing any single antidepressant on a group of
depressed individuals will show that many of them do not improve.”
What do other findings show about using antidepressants?
Numerous studies support the benefit of antidepressants in improving mood,
increasing ability to function socially, and easing physical complaints of
joint pain, insomnia,
and low energy.
According to Ronald R. Fieve, MD, psychopharmacologist and professor of
clinical psychiatry at Columbia Presbyterian Medical Center in New York City,
its not unusual for an antidepressant to take two to six weeks to have an
effect on a patient’s mood.
“People must realize that we’ve come a long way in reducing the side
effects of antidepressants since first prescribing the tricyclics,” Fieve
says. “And while drug companies have reduced medication side effects with
the newer [antidepressants], there’s still not much improvement with onset of
action or efficacy.”
Fieve notes that in his practice, a good number of patients dramatically
come out of their depression within 10 days to two weeks. “About 65% see
improvement on the first antidepressant, and 85% of patients succeed on one to
three antidepressant trials.”
Why wouldnt an antidepressant work?
According to Fieve, sometimes the doctor chooses the wrong antidepressant,
or the right antidepressant in the wrong dosage, or does not administer the
antidepressant for at least six weeks at the highest dose tolerable to achieve
full therapeutic results.
In addition, if the depressed patient has problems with alcohol or drug
abuse and takes an antidepressant, the medication isn’t getting at the real
problem. There are also patients who are heavily medicated on tranquilizers who
wonder why an antidepressant doesn’t work to ease their depression. Coming off
the tranquilizers may improve mood, Fieve says.
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