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medication for depression

Mind-Body-Mood Advisor: The Unhappy Truth about Antidepressants

A new study shows that medication is not a one-size-fits-all solution for depression.

By Jeffrey Rossman, PhD


Mind-Body-Mood Advisor: The Unhappy Truth about Antidepressants

We're focusing too much on medication for treating depression, new research implies.

RODALE NEWS, EMMAUS, PA—Twenty-seven million Americans—10 percent of women and 4 percent of men—are taking medication for depression. If you find that surprising, consider this: According to a study published this month in the Journal of the American Medical Association, most of them could get as much relief from taking a placebo. The study calls into question the widespread practice of prescribing antidepressant medication for people who are mildly or moderately depressed. Rather, it supports reserving the use of the drugs for severely depressed patients, those who feel hopeless and have trouble eating, sleeping, working, and performing tasks of daily living.

THE DETAILS: Researchers at the University of Pennsylvania analyzed the results of six drug trials, which included 718 patients taking medication for depression. The study authors found that the antidepressants studied, paroxetine (sold as Paxil and Serixat) and imipramine (sold under various names, including Antideprin, Deprinol, and Imipramil), were effective only for the most severely depressed patients. For patients with mild to moderate depression, and even some patients in the less-severe portion of the major depression category, medication for depression performed no better than placebo. That is, no better than a sham treatment such as a sugar pill.

With antidepressants in such widespread use, how is it that this phenomenon went unreported until now? In fact, most drug studies are done with severely depressed patients, the group that according to this data is most likely to show improvement with drug therapy. The six trials included in the JAMA article are among the very few that included less-depressed subjects, and thus, could yield a comparison between less and more depressed patients. By focusing on patients who had the most severe forms of depression and getting good results, most of the research done on antidepressants created the perception that all depressed people would benefit from their use.

Next page: What it means.

Filed Under: DEPRESSION, MIND-BODY-MOOD ADVISOR, PRESCRIPTION DRUGS

Published on: January 25, 2010



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Some individuals who are

Some individuals who are prescribed antidepressants often pressurize their doctor for increased dozes or a quick change of medication because they do not experience much relief. It is crucial to understand that antidepressant is not a quick fix, it takes its own time to work which may be from a few days to weeks and you need to be patient.
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Antidepressants addiction

I wanted to quit taking antidepressants once I decided that I was ready to get pregnant.Unfortunately just stopping abruptly wasn't a good idea, I had very unpleasant withdrawal symptoms.I went to a rehab center.It took me a lot more time than I was expecting when I first came with the decision,but I'm glad I did this step.

Nutrition Remedies

Reader

It's great you have found mood-enhancing lifestyle practices that complement medication. As for nutrition-mental health resources I can recommend several: 1) Check the links to previous articles I included in the final section of this article, 2)See if you can find a nutritionist, naturopath, physician, chiropractor, acupuncturist, or psychotherapist in your area who is trained in nutritional approaches to mood. 3)Look for courses or workshops on this topic being offered in your area. 4)Two good books you may find helpful are The Ultramind Solution by Mark Hyman, MD and Healing Anxiety and Depression by Daniel Amen, MD and 5)Check our website for future articles on natural approaches to enhancing mood.

Depression and antidepressants

Catlady 33875

Thanks for your thoughtful response.
I agree that anyone who truly needs medication should not discontinue it. However it should not be used to the exclusion of psychotherapy, exercise, good nutrition, sleep, etc. I also agree with your last comment about the placebo effect-- it can motivate people to pursue change. People's moods improve with placebos because they become hopeful. Hope is an antidote to depression! It can motivate people to engage in constructive activities and self-care.
It's great that you've been researching depression. Hopefully, you'll find what combination of approaches works best for you.

Antidepressants and depression

Susan,

People who take medication often benefit, in addition, from eating a healthy diet, exercising, and developing effective coping skills. The good news is that these approaches are also helpful for Diabetes and Chronic Fatigue Synrdrome. I know it's a challenge to exercise with Chronic Fatigue Syndrome, but as you have found, low intensity exercise can be very helpful. The trick is to not overdo it. The links in the last part of this article contain useful information about nutrition and coping skills to help with depression. Good luck!

Nutrition remedies

For years I have wanted to see a nutrition-mental health connection resource. I have long thought there is a direct link and that poor nutrition, sleep habits, exacerbate existing mental illnesses.

I have a depression diagnosis and have tried to reduce meds but also without success. When I follow a routine and complement the medication with good foods, sunshine, steady sleep habits, meditation, talk therapy, other remedies like "natural healing" practices, it makes a world of difference.

Ideally when a person is taking these medications she would feel more inclined to practice good self-care like this article recommends. In my experience with traditional doctors they do not talk to patients enough about a person's lifestyle and routine before prescribing drugs.

It is very hard to make sensible choices when you are major depressed. You need a strong support system to remind you to eat well, etc.

By the way I like these articles and would love more interaction with articles' authors or website editors here.

Depression and antidepressants.

I understand the subject of the article, but I am always concerned when people are advised to not take antidepressants. I suffer from recurrent depression which is genetic in my family and has often resulted in alcoholism. I have been taking antidepressants since I discovered that I was becoming unable to function without them. "The Unhappy Truth" is that our society expects to be able to pop a pill to solve things and that our health care insurance will pay for prescriptions instead of psychotherapy. I researched depression and my minor in college was psychology. Yes, talk therapy, exercise, better coping mechanisms, all of these things should be used to combat depression. However, our society still views mental illness with suspicion and it has become socially acceptable to take antidepressants. I am not an advocate of taking prescription medicine unnecessarily, but if the only way a person seeks help is by taking a prescription I'm not convinced it's not better than nothing. Perhaps even the placebo effect will give the individual the motivation to pursue change.

Antidepressants and depression

I have chronic depression (severe) and am bi-polar, type 2. I am one of those who does much better on medication. My daughter is also chronically depressed, and without her medication, she can't cope with everyday activities.

We both do better with healthy diets and exercise; however, I have exercise intolerance due to Chronic Fatigue Syndrome and can only do a little walking and some restorative yoga.

I have tried to get off medications before, with bad results. However, I would like to take LESS medication, and am hopeful that with some of these strategies I may be able to.

I have been diagnosed with thyroid problems (underactive), hormone imbalances (for which I take bio-identical hormones), and diabetes type 2, among others. I'm sure these illnesses contribute to the depression; I'm not sure about the bi-polar.

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