Monday, February 16, 2009

Are All Anti-depressants created equally?

Historically, it has been reported that the overall effectiveness of the newer and older anti-depressants were all about equally effective, differing in their side effects. A very recent article in The Lancet disputes this, comparing the effectiveness of 12 of the newer anti-depressants for Major Depression in adults. It looked at side effects, as well.

A summary of their findings found the following to be more effective:


They also reported the following to be less effective:

Edronax (least efficacious)

Lexapro and Zoloft were found to have significantly fewer discontinuations due to side effects.

This does NOT mean that if you are taking one of medications found to be "less effective" and it is working, that you should change. Nor does it mean if you are taking one of the "more effective" medications and are having difficult side effects, that you need to continue that medication.

Any medication is the Best medication for one person and the Worst for another. It is imperative that you consult and work closely with your prescribing physician.

An earlier post of mine Drugs vs. Therapy (9/5/08) compared the effectiveness of each. Here is a summary:

Many of the studies with depression, even severe depression, show them to be about equally effective. Therapy has been shown to have greater durability, with lower relapse rates following the end of treatment. There are also lower drop-out rates for therapy, due to medication side-effects. It is common practice for people to receive both treatments. One might think this to be more potent than either treatment by themselves. Some studies do support this, but other studies do not.

Best wishes,

For a Summary of the article:

Monday, February 9, 2009

Get on Your Feet

If you are dealing with anxiety and/or depression, exercise is something that you should begin, increase, or continue. There is 40 years of research that exercise is not only be very helpful, but some studies indicate they work better than anti-depressant medications, especially in follow-up studies! The self-help group Recovery, International (formerly Recovery Inc.) has taught for over 70 years that when depressed to "move your muscles.” Sleep quality and insomnia often improve with exercise.

It is best to consult with your physician before beginning a mild to moderate exercise program. Often, walking is a great place to begin. No special equipment is necessary and you can do this year round. In winter, many go to indoor malls to walk. Start at a comfortable pace and don't over do. Even 10 minutes has been shown to be beneficial.

The trick is to find something that you don't hate and preferably enjoy. Studies generally utilize 20 to 60 minute sessions at least three times a week, although you may not be ready to begin at that length of time. Nor do you necessarily have to join a gym. Finding someone to exercise with can be very helpful, but should not be an excuse to not exercise. Consider walking with your spouse or a friend. Bike ride with your kids. Consider exercise classes.

Having different things that you sometimes do can help keep things from getting boring. However, if you say love and want to primarily do one activity, Great! Changing where you walk, run, bike, etc. can also help keep things more fresh. Another advantage of sometimes doing different things is using different muscles.

Exercise is not guaranteed to beat your anxiety or depression alone, but it frequently is very helpful.

Best wishes,

Sunday, February 8, 2009

What is Your Recovery Plan for Anxiety and Depression?

What is your recovery plan? What is it that you will do to get past your depression, anxiety, or whatever? This may be a foreign concept to you. Many may wonder, “What is it that I CAN do to improve my anxiety, mood, or whatever? Non-medication possibilities include (but are not limited to) exercise, self-help reading, tracking and challenging negative thoughts, self-help group involvement, facing your fears, affirmations, diet, spiritual practices, relaxation exercises, yoga, and journaling.

Whether or not you are seeing a therapist, generally, the more you do the kind of things just mentioned, the more quickly you get better. If you are working with a therapist, it is best to check your activities with them. Most of the time, you will get encouragement and possibly tips. Many to most therapists will gladly make suggestions of thing they think you will find helpful.

If you have experienced a lot of trauma and/or very severe trauma, then trying to recall memories and some self-help reading may take you at a faster pace than you can manage. In these cases, it is better to go too slow than too fast. However, it does not preclude you from doing most of the other activities listed above.

Activities that are often suggested and helpful are to think about different things related to what you want to change, to notice the times when things are actually better, as well as trying to picture in your mind how you would like things to be.

Best wishes,
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