To alleviate boredom while travelling, often times the only thing to do is read. During the course of a recent business trip, I encountered an article calling into question whether antidepressants work as advertised. The findings suggest that SSRI and SNRI type antidepressants may not work much better than a placebo at alleviating the symptoms of depression.
The study I read was a meta-analysis (a study of other studies), and according to the authors, when patients were evaluated on the Hamilton Rating scale of depression, the antidepressants work only marginally better than a sugar pill at relieving the symptoms of depression. In 2007 U.S. doctors wrote $11.9 billion dollars worth of prescriptions. This is a staggering number, so the stakes are huge. The study has engendered debate in psychiatric circles, as well as having prompted other meta-analysis. At least two of these other studies reached similar conclusions, which indicate that a sugar pill can replicate about 80% of a patients response to SSRI-style drugs.
SSRI drugs are Selective Serotonin Reuptake Inhibitors. This means that they increase the concentration of serotonin in the brain. Serotonin is thought to be related to mood, with low serotonin levels being responsible for feelings of depression. This is a logical course of attack for a condition based on a chemical imbalance, but even the exact link between serotonin and mood is not well understood.
The subject gets even more cloudy as these studies are expanded. It seems to be a well-accepted fact that women are more often diagnosed with depression than men.A recent study showed that citalopram (a commonly prescribed antidepressant) worked better for women than men, when used to treat major depression.In addition, there have been several studies that indicate a potential link between not only gender, but genetics, when it comes both risk and responsiveness to treatment for depression.One such study can be found below:
ScienceDaily (2008-06-04) — If a better understanding of genes may lead to customized therapies for schizophrenia, can the same be true for new depression treatments? Answering this question is especially important now that a 2006 government study found that a significant number of people with clinical depression — more than half — are not helped by their initial course of antidepressant treatment, whether medication or talk therapy. … > read full article
Academic interest aside, there can be no doubt that many people have benefited from this class of drugs, whatever the mechanism of action. Regardless if what the academic studies say about how antidepressants work, if they offer relief for you, that’s all that matters. However, if you decide to try drug therapy for depression, just remember that these drugs affect brain chemistry. Be certain to read about and understand the side-effects, and stay in close contact with your doctor regarding dosage and effectiveness.
