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Nancy Schimelpfening

Antidepressants May Only Work Well for Severe Depression

By January 6, 2010

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The benefits obtained from antidepressants may vary according to the severity of the patient's depression, says a new article appearing in the January 6, 2010 issue of JAMA, and they may only provide significant benefit  for those with severe depression.

Jay C. Fournier of the University of Pennsylvania and his colleagues conducted a meta-analysis to estimate the benefit of antidepressant treatment vs. placebo across a wide range of initial symptom severity in patients with depression, combining data from six large-scale, placebo-controlled randomized trials including 718 adult patients.

The authors found that the efficacy of antidepressant treatment varied considerably and was dependent upon how severe the patient's depression was. True drug effects (defined as an advantage of antidepressant treatment over sham treatment with a non-drug placebo) were non-existent to negligible among patients with mild, moderate or even severe depression symptoms. They were, however, large for patients with very severe depression symptoms.

"What makes our findings surprising," say the authors, "is the high level of depression symptom severity that appears to be required for clinically meaningful drug/placebo differences to emerge," especially since the majority of patients receiving antidepressant treatment appear to have depression below these levels.

Efforts should be made, the authors conclude, to clarify to clinicians and patients that whereas antidepressants can have a substantial effect for those with more severe depression, there is little evidence to suggest that they give much benefit for those with less severe depression.

Comments
January 6, 2010 at 2:18 am
(1) Stevie says:

That is depressing news.

January 6, 2010 at 4:27 pm
(2) laurie Schloff says:

I tried many drugs and they made me feel worse.
I became myself on Effexor and thank my lucky stars that such a wonderful medication exists.

January 6, 2010 at 10:53 pm
(3) Elizabeth Hensley says:

Antidepressants really helped my Mother and they still help me A LOT, My Mother only gave me one hug in 30 years and that was after I got her help for her depression. She also let us finally throw away decades of spoiled and ROTTING food, composting newspapers, used food containers, etc. She had severe depression and hoarding OCD and hypothyroidism. Due to sleep apnea, non wheezing type asthma, not enough serotonin and too much glutamate I could NOT sleep and had migraines EVERY SINGLE DAY in High school and most of my young adult life. I found out tryptophan would help but not enough. Even with large doses of tryptophan it took 16 hours a day to get enough sleep. Antidepressants cut that down to 11 hours or less and my moods were beter and I had fewer migraines. I found out years later I have heavy metal poisoning which was causing mild autism, hypothyroidism, and adrenal fatigue. I knew for years that I had malabsorption syndrome from gluten intolerance that was not caught soon enough before damage to my gut and that also damaged my brain. I also found out that glutamate which is in every live virus shot and which the FDA allows to hide in foods under 40 different names (go to msgtruth.org) was a big factor in my troubles and also take a glutamate blocker now which also helps some and avoid glutamate in food but it is not easy to do! (But I do not have ANY autistic melt downs when I manage to avoid it). It is true when some people first start off on AD’s they get energy they did not have, before their moods are lifted and during this danger period they can make very unwise decisions and commit violent acts. But that danger period is temporary. (But people newly on these meds should be watched very carefully). But a study in Sweden showed even during this danger period suicides and violent acts towards self and others actually go down compared to depressives not on meds. In many cases the medications are getting the blame for what the illness is actually causing. Because people do violent acts all the time and if they are not on meds the fact they have untreated depression that was a big factor in what they did does not get recorded in the newspapers and public records. But if someone on medication commits a crime, that gets recorded and broadcast.

January 10, 2010 at 12:12 pm
(4) John@how to beat depression naturally says:

This article just goes to show you that antidepressants are a serious drug and should only be considered if you have a serious case of depression. If you are suffering a lesser form or a milder form of depression, you would do yourself a big favor by trying some natural alternatives first.

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