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Are antidepressants helpful for only severe depression?
Posted Thursday 14 January 2010
Making the news in the USA is research that indicates that mild and moderate depression are not lifted by antidepressants, which are only useful for severe depression (though the research methodology has come in for some critcism).
The research concludes that if a person experiences mild or moderate depression then medication should be just one of the options available.
This side of the pond, National Institute for Health and Clinical Excellence (NICE) guidelines already states that antidepressants should not be the first choice in treating mild depression but may be of use for people with a past history of moderate or severe depression.
Of course guidance and practice aren’t always in step and it was reported last year that prescriptions for antidepressants are on the rise and recently that GPs prescribe antidepressants even if they feel another treatment might be more beneficial as that treatment is not as readily accessible.
The government had pledged £173 million towards mental health care. The Improving Access to Psychological Therapies (IAPT) scheme is designed to combat the reliance on prescribing medication for mental distress by offering accessible alternatives. There is some uncertainty over how the scheme is faring, with reports late last year that it has experienced difficulties, including only 400 of the required 3,600 therapists trained, although IAPT disputes this figure and other aspects of the article.
With any luck headlines about the best treatment options for depression and will strengthen the government’s resolve to keep supporting a wide range of treatment options for the millions who experience depression and other mental health problems.
Bridget O'Connell, Head of Information
3 Comments
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Does it really matter what we, the poor swodding patients, think?
SSRIs aren't the treatment of choice for mild depression. They're only useful in severe depression for bringing the patient to the point where other treatments can be applied. Research has consistently shown that 'talking treatments' are more effective in the long run. But drugs are easy.
SSRIs have been over-prescribed to the point where those of us who need them to keep functioning are in danger of losing them altogether. Lifestyle drugs indeed.
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I'm by no means an expert but have always wondered about whether tablets are the best way to go with depression. It's like when you're trying to give up smoking - nicotene gum, patches etc. will not work without willpower and I think with depression it's the same, i.e. the tablets will only work in the long term if someone wants to beat depression. I may be talking complete nonsense and I think it varies from person to person whether tablets are the way forward or not, but I always think of anti-depressants as treating the symptoms whilst ignoring the underlying cause. Depression is not something that just vanishes - it will always be a part of who someone is who has suffered from it and can lie dormant then be triggered by a number of factors, although there are a number of lifestyle choices that can help to minimise its impact, such as keeping both body and mind active, getting plenty of sleep, eating healthily and avoiding intoxicants.
I certainly think that tablets should only be used when other more natural methods have been tried and failed. I'm not sure if I'm so anti-tablets due to having dependencies on drugs and alcohol in the past - this is probably a factor. I could keep on about this for hours so had better stop now. Am interested to hear what others think.
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My husband has clinical depression and takes venlafaxine and I take Citralopram for anxiety. My husband attempts suicide at least once a month. Some people have suggested that he go into the psych hospital and get his meds changed. I don't think he could live without his meds but I understand the addiction factor problem.
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