Thursday, January 14, 2010

Commentary About Study Questioning Anti-Depressants Effectiveness for Mild to Moderate Depression

An article just published in The American Journal of American Medicine (JAMA) questions the efficacy of the use of anti-depressant medications (ADM) with mild to moderate depressions. The article is not an easy read! Here is an abstract from JAMA.

It looked at six studies with randomized control groups. Three of the studies evaluated imipramine (an older anti-depressant) and three evaluated Paxil. The conclusion is that ADM may be no better than placebo for mild to moderate depression. Further, that there was greater change with ADM as the depression was more severe. The authors reported that it has been known for more than 50 years that more severe medical and psychiatric conditions respond to a greater degree than less severe conditions.

It was also reported that FDA studies of ADM study only those with severe depressions, which they correctly report are not the impressions that Pharma's advertising gives us.

One statement in the Abstract is questionable: “Antidepressant medications represent the best established treatment for major depressive disorder.” Studies comparing ADM with several brief psychotherapies show that the latter are equally effective to ADM. Other studies show regular exercise to also be very effective. Further, therapy and exercise have dramatically lower relapse rates.

So what does this mean if you are on ADM? My suggestion is that if it is working, continue it. Don't suddenly stop altogether. Direct your questions and concerns to your prescribing physician. However, be aware that much of what many physicians know about medications, especially newer ones, is given to them by drug representatives.

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