Antidepressant Articles

What If a Sugar Pill Was Just as Effective As Psychotherapy?

Wednesday, June 26th, 2013

What If a Sugar Pill Was Just as Effective As Psychotherapy?Yum, sugar pills! We talk about them all the time in science, where they have a much more formal and less appetizing name — placebos.

A placebo is simply something used in research to act as a treatment equivalent, so as to not bias either the research subjects or the researchers themselves in how they perceive and react to the experimental treatment. In research on drugs, this often means giving one group of patients pills that look just like the medicine being studied, but lacking any active ingredient.

In recent years, new research has emerged looking solely at the studies that were used to gain FDA approval of antidepressant medications (some of which were never published). When taken together, the studies found that antidepressant medications may not be as effective as previously thought (but what any patient who’s ever tried them could’ve told us decades ago). This recent research found effect sizes of just 0.31.

Which got some researchers to wonder… If antidepressant drug treatment effect sizes might be lower than we had thought, could the same be true for psychotherapy effect sizes too?

Could, in fact, a sugar pill offer as much change in one’s depression as months or years of intensive psychotherapy?

How the DSM-5 Got Grief, Bereavement Right

Friday, May 31st, 2013

How the DSM-5 Got Grief, Bereavement RightOne of the charges leveled against psychiatry’s diagnostic categories is that they are often “politically motivated.” If that were true, the framers of the DSM-5 probably would have retained the so-called “bereavement exclusion” — a DSM-IV rule that instructed clinicians not to diagnose major depressive disorder (MDD) after the recent death of a loved one (bereavement) — even when the patient met the usual MDD criteria. An exception could be made only in certain cases; for example, if the patient were psychotic, suicidal, or severely impaired.

And yet, in the face of fierce criticism from many groups and organizations, the DSM-5 mood disorder experts stuck to the best available science and eliminated this exclusion rule.

The main reason is straightforward: most studies in the past 30 years have shown that depressive syndromes in the context of bereavement aren’t fundamentally different from depressive syndromes after other major losses — or from depression appearing “out of the blue.” (see Zisook et al, 2012, below). At the same time, the DSM-5 takes pains to parse the substantial differences between ordinary grief and major depressive disorder.

Unfortunately, the DSM-5’s decision continues to be misrepresented in the popular media.

Taking an Antidepressant: Sanity and Vanity

Sunday, April 21st, 2013

Taking an Antidepressant: Sanity and VanityAt first the weight gain from my new antidepressant didn’t bother me. All I cared about was that this medicine was working. I felt myself coming into my body again; I could experience emotions and enjoy the present; I wanted to do things again.

One of those things was eat ice cream. A lot. So I gained a few pounds. It was time to buy new pants anyway. The only important thing was that my medicine was working and I was feeling good. I felt like participating in my life again. Feeling good and eating ice cream were natural.

But then I broke the couch.

Cognitive Behavioral Therapy and Depression

Wednesday, March 27th, 2013

Cognitive Behavioral Therapy and DepressionIn this age of advanced modern medicine, it is a depressing fact that not all people suffering with a depressive illness respond to antidepressants.

The mental health charity Mind UK recently highlighted their concern that there is a serious need for a range of therapies to be made available to depression sufferers.

According to the best psychological working practices, medication is now considered to be only one option for effectively treating the illness.

Talk therapies — otherwise known as psychotherapy — such as cognitive behavioral therapy (CBT) have proven effective at alleviating melancholic symptoms in hundreds of research studies conducted around the world. In Australia, the Australian Psychological Society has identified a serious need for psychotherapeutic interventions in the lives of people with depression.

Defusing Shame by Sharing It

Saturday, March 16th, 2013

Defusing Shame by Sharing ItShame really should be on the list of deadly diseases. It may not actually murder a physical body, but it has the capacity to barrage the soul to the point of psychological imprisonment. It attacks our sense of self-worth and destroys our ability to be fully alive.

If it were actually effective, I would wholeheartedly join you in your strike against shame, holding signs to keep it out of the psyche and saying, “Shame on you, shame.” But from my experience, it usually just grows into an angry beast. It haunts us day and night until we do something about it.

Pushing away the shame isn’t the answer. So what is?

Sharing the shame with a trusted person is what will heal us.

New Anxiety, Bipolar and Depression Drugs in the Pipeline?

Thursday, February 28th, 2013

New Anxiety, Bipolar and Depression Drugs in the Pipeline? What happens when the drug pipeline for common mental health concerns — such as depression, anxiety and bipolar disorder — starts to dry up?

“Most psychiatric drugs in use today originated in serendipitous discoveries made many decades ago,” according to a recent article on Science News by Laura Sanders. And it’s true — we can trace back today’s most popular psychiatric drugs to discoveries made over 30 — and in some cases, 40! — years ago.

Because of the heady cost of drug development — costing hundreds of millions of dollars to bring a new drug to market — most pharmaceutical companies have been playing it safe these past few decades. They’ve been working on developing “me too” drugs — subtle molecular changes to existing compounds.

Which means the pipeline is darned near empty of truly new drugs likely to come out in the next 5 to 10 years for the most common types of mental illness.

Withdrawal from Psychiatric Meds Can Be Painful, Lengthy

Wednesday, February 13th, 2013

Withdrawal from Psychiatric Meds Can Be Painful, LengthyAlthough this will not come as news to anyone who’s been on any one of the most common psychiatric medications prescribed — such as Celexa, Lexapro, Cymbalta, Prozac, Xanax, Paxil, Effexor, etc. — getting off of a psychiatric medication can be hard. Really hard.

Much harder than most physicians and many psychiatrists are willing to admit.

That’s because most physicians — including psychiatrists — have not had first-hand experience in withdrawing from a psychiatric drug. All they know is what the research says, and what they hear from their other patients.

While the research literature is full of studies looking at the withdrawal effects of tobacco, caffeine, stimulants, and illicit drugs, there are comparatively fewer studies that examine the withdrawal effects of psychiatric drugs. Here’s what we know…

Transcranial Direct Current Stimulation: A New Electrical Treatment for Depression?

Wednesday, February 6th, 2013

Transcranial Direct Current Stimulation: A New Electrical Treatment for Depression?When electricity and the brain are mentioned in the same sentence, your mind might immediately jump to disturbing images of people receiving huge shocks while covered in electrodes, strapped to tables.

But electroconvulsive therapy (ECT) treatment has developed considerably since the days depicted in “One Flew Over the Cuckoo’s Nest.”  A current study at JAMA Psychiatry examines a treatment called transcranial Direct Current Stimulation (tDCS).

Could this fairly new form of electrical treatment for depression really be effective — and without the negative side effects of ECT?

A Pep Talk for Those With Treatment-Resistant Depression

Thursday, January 24th, 2013

A Pep Talk for Those With Treatment-Resistant DepressionIn his book, Understanding Depression: What We Know And What You Can Do About It, J. Raymond DePaulo Jr., M.D. asserts that for the 20 percent of his patients who are more difficult to treat, or “treatment-resistant,” he sets an 80 percent improvement, 80 percent of the time goal. And he usually accomplishes that.

Now, if you’re not someone who has struggled with chronic depression, those stats won’t warrant a happy dance.

But if you’re someone like myself, who assesses her mood before her eyes are open in the morning, hoping to God that the crippling anxiety isn’t there, then those numbers will have you singing Hallelujah.

Could Aspirin, Advil & Other NSAIDs Keep Antidepressants From Working?

Wednesday, December 19th, 2012

Could Aspirin, Advil & Other NSAIDs Keep Antidepressants From Working?Have you told your doctor about the other medications or drugs you regularly take? If you’re on an antidepressant, you probably should.

If you’re taking non-steroidal anti-inflammatory drugs (NSAIDs), you may be less likely to experience the beneficial effects of the most commonly prescribed classes of antidepressants, SSRIs (such as Paxil, Zoloft and Prozac).

NSAIDs include ibuprofin (such as Advil, Motrin, and Midol), naproxen sodium (such as Aleve) and good ole aspirin.

According to an article appearing in the recently published The Carlat Psychiatry Report, that was the surprising conclusion of a paper published last year (Warnerschmidt Jl et al, Proc Natl Acad Sci USA 2011;108:9262–9267), and a newly released report reaches a similar conclusion.

Research Suggests Pregnant Women Forgo Antidepressants, With One Exception

Monday, November 5th, 2012

Research Suggests Pregnant Women Forgo Antidepressants, With One ExceptionConventional wisdom has been for women who are taking antidepressant medication, to stay on it even while pregnant. Try to discontinue such medications can often be a long, slow process that has its own ups and downs. (Ask anyone who’s ever been on antidepressant for a year or more — it’s not fun trying to get off of it.)

It turns out, though, that conventional wisdom is largely wrong. Most infertile women who are taking popular antidepressants — such as Prozac, Paxil or Celexa — would help their unborn child by discontinuing the medication. With one exception — those women who are suffering from a severe depression (versus mild or moderate depression).

Why? Those women taking antidepressants nearly double the risk of a miscarriage if they stay on them during their pregnancy.

Budeprion XL 300, Generic Wellbutrin, To Be Withdrawn

Friday, October 5th, 2012

Budeprion XL 300, Generic Wellbutrin, To Be WithdrawnIn 2007, The People’s Pharmacy, a newspaper drug advice column by Joe and Terry Graedon, noted on their website that they started getting reports from people taking a generic form of Wellbutrin called Budeprion XL 300 mg. These reports discussed how patients taking the generic version of this antidepressant weren’t experiencing the same beneficial effects of the medication as when they were taking the name-brand version. And the side effects were often worse.

The Graedons became so concerned that they commissioned an independent lab analysis of the generic version of Wellbutrin manufactured by Impax Lab and Teva Pharmaceuticals in 2007. This report found that the generic version of Wellbutrin simply wasn’t equivalent to the brand-name version.

In April 2008, the FDA reviewed their existing studies, and concluded they were the same. The FDA did not review the independent analysis, or any actual data on the 300 mg version of the product (you know, the one people were actually complaining about).

Here it is more than four years later, and the U.S. Food and Drug Administration (FDA) finally agrees with the independent analysis, the Graedons, and the hundreds of people who’ve complained about the efficacy of Budeprion XL.

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