Wednesday, January 6, 2010


I am not exactly going to blog about depression. In a bit of irony however, a research study was published in JAMA regarding the effectiveness of a few psychotropic medications I mentioned in my blog about anxiety yesterday. With the Penn State study and a previous study from the University of Hull (UK), comes more evidence that these drugs, at least in the treatment of depression, are not a panacea and may not even be a temporary fix.

Several schools and several researchers were involved in both studies. They
evaluated existing clinical trials, some which weren't published but made available through the freedom of information act, and they LOOKED BEYOND THE HEADLINES... In some cases of severe depression, which was not defined, but from my experience would include persons with nihilistic delusions, severe apathy, extreme weight loss or gain and inability to function - there was some effect, with some of the drugs, some of the time. BTW, electroconvulsive therapy also works!

Instead, most studies show that there was no difference between the drug and a placebo. With the great risk associated with these drugs, mostly weight gain and then diabetes, that should be a treatment changing finding. This is the type of research we need. Billions of dollars are spent on these drugs - Paxil, Prozac, Zoloft, Effexor and more.

One drug company that responded to the study said that the design of their studies and the university studies were not the same so they really weren't going to comment beyond noting that their medications had improved the quality of life for many people who take them.

Drug companies say that they are not creating the drugs for people with mild to moderate depression, but you sure wouldn't think that from watching their ads. If anything, they seem driven to convince us all that we have clinical depression and their pill could eradicate it in a day. Truth be told, even when drugs are deemed effective, it is after several weeks of taking them.

Two things in the Forbes article by R. Langreth are worth repeating. One clinician advised that alternatives to medicine should be considered and that includes exercise and talk therapy - I am sure that some of the strategies for managing stress in yesterday's post would also be helpful.
Another scientist noted that the idea that drugs that keep serotonin (a mood stabilizing neurotransmitter) available in the brain (uptake inhibitors) really were not effective and that the idea that a lack of serotonin leading to depression is a MYTH! I think they should concentrate on endorphins and dopamine which is probably why so many studies do show that exercise is at least as effective as drugs in treating this condition and a helluva lot safer.

I will share a personal story with you now. It is something that happened to me at least a hundred years ago, or maybe ten...

I was having a bad time and went for some counseling. This was after my first round of college but before my graduate work, etc. I saw the counselor a few times and then one day she said, "I spoke with your insurance company and they think the best thing to do, the thing that will work the fastest, is to put you on medication - an antidepressant." I cannot in words express to you how angry I became. I certainly used very bad language. I could not believe that I had come in to get a sense of direction, do a little brainstorming and goal planning and was told that I had clinical depression and needed pills. I told her that I would not take medicine, I was not depressed, but had issues with the way my life was going - or the path I was on. I was unhappy, yes, but I was going through a crisis. She did say, something like wow, that is the first real emotion you've shown since we started. WHATEVER! :) But you know, this was a turning point to me and what I said to her then is very important for all of us.

I was going through a crisis. And contrary to what Big Pharma wants you to believe, life stresses and even significant crisis do NOT require medication and even if they did, the ones out there do NOT work. I am not talking clinical and severe depression and please, never abruptly (or without telling your doc) stop a medication that you have been prescribed, but also know that sometimes the only way out of something is through it - you have to take one step at a time and get through it. Exercise and writing or talking things out - that'll help.

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