Antidepressants revealed

First came the warning of a possible link between selective serotonin reuptake inhibitors and suicidal thoughts among children and adolescents. Then came a drop in sales — 14% last year compared with the year before. Now research has found that a single medicine typically does not effectively treat depression for most people and that those with depression often stop taking the medicines altogether.

Clearly, a one-size-fits-all approach will not suffice. Patients who complained to their internists about feeling blue have not been well-served by simply a prescription for an SSRI — and few warnings about side effects or the very real possibility that the drug might not work.

A study published in the January issue of the American Journal of Psychiatry, found that a single SSRI medication works only for about 30% of chronically depressed patients. For most of the 2,876 outpatients participating in the study, real progress came only with subsequent drugs or with a combination of drugs.

A second study, published Thursday in the New England Journal of Medicine, looked at the remaining patients who did not respond to the single medication the first time. More than half of this group switched medications completely, and about a quarter of them became symptom-free within 14 weeks. An additional 565 augmented the initial antidepressant with a second medication, and within 14 weeks of treatment, one-third became symptom free.

The sheer dimensions of depression illustrate the importance of treatment. A massive study conducted by the World Health Organization, Harvard University School of Public Health and the World Bank, found that by the year 2020, depression will be second only to heart disease in terms of disability caused. In any one-year period, 9.5% of the population, or about 18.8 million American adults, suffer from a depressive disorder, according to the National Institute of Mental Health. And though less than half seek treatment, many try to get help from their primary care physician or, less frequently, a mental health professional.

As currently offered, even treatment is no guarantee that the depression will lift. Each year, however, new research produces greater understanding in the treatment of this often-debilitating illness. And physicians are becoming more appreciative of a holistic approach to treating it, using not just therapy but diet and physical activity as well.

Excerpts courtesy of the LA Times

Steve - I think the most important sentence in this summary was the last one. Diet and physical activity have an enormous effect on depression.