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:

Remeron
Lexapro
Effexor
Zoloft

They also reported the following to be less effective:

Cymbalta
Prozac
Luvox
Paxil
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,
Mike

For a Summary of the article: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60046-5/fulltext

3 comments:

Tracy's Photogaphs said...

The best anti-depressant for me was wellbutrin, but since I can no longer afford it, I have switched 2x to Celexa and then to Prozac (not including the increases of dosage) and since being on Prozac 30 mgs, I have added two more to the mix: abilify and valproic acid.

As GOD as MY witness, I will never go on effexor again, which I was on in my early 20's. That was about the time I nearly ended up in the psych ward

Mike Miller, PhD said...

Again, ANY ed will be Best for one person and Worst for another. At one time, I heard that over 500 people a year die from aspirin (usually due to bleeding ulcers, I think). Don't know if that is still true. Thanks for comment.

Best Wishes,
Mike

Tracy's Photogaphs said...

Per last comment...I just read that Effexor shouldn't be taken by those who are younger than 24. I was 22 or 23 when prescribed to me. Perhaps that was the root of some of my problems with that med? I'm content now, but do you think things would be different now that I in my 30's?

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