Lancet Study Ignores Significance of Side Effects
A new meta-analysis study was published today in the journal Lancet which showed that two antidepressant drugs — Lexapro (escitalopram) and Zoloft (sertraline) — were more effective than their psychiatric peers. Remeron and Effexor fared better, too, than the other drugs included in the analysis, such as Prozac, Cymbalta, Luvox and Paxil.
The study looked at two components important to treatment — efficacy (how much does this drug actually help reduce depressive symptoms) and toleration of the drug (how many people stop taking the drug because it simply can’t be tolerated by their body), as measured by drop-out rates.
However, the study did not look at a drug’s side effects, which is a major component of finding a psychiatric drug that’s appropriate and “works” for any given person. A drug isn’t of much use if the side effects are as bad as the original symptoms the drug was meant to treat. Or if the side effects make one’s quality of life only slightly better than when not taking the drug. Or if the side effects result in longer-lasting physical concerns, such as tardive dyskinesia. (I’m not aware of too many people willing to reduce their depressive symptoms now for serious bodily movement problems 10 years from now.)
For instance, many antidepressants have a side effect of lack of sexual desire or other sexual issues. That can cause all sorts of additional problems in a person’s life, in addition to dealing with the symptoms of depression. Many doctors offer simplistic solutions to such problems (Hey, let’s add some Viagara to your treatment!), without bothering to listen to the patient’s concerns in-depth.
I think studies such as this are, at the end of the day, of little value to most people. You’re not going to stop taking an antidepressant that you’re on if it’s working for you. And if you tried Zoloft in the past and it did nothing for you, this study isn’t suddenly going to help make the drug effective for you.
Perhaps it can help guide a physician in their initial prescription choices, but most doctors already have “favorite” antidepressants they’re most comfortable and familiar with prescribing.
A single study, even a meta-analysis of this nature, isn’t likely to change many doctor’s prescribing behaviors.
So at the end of the day, we’re left with pretty much the same recommendation — find an antidepressant that works for you with tolerable, minimal side effects. And then stick with it.
Read the full article: Lexapro and Zoloft Top Treatments for Depression
Grohol, J. (2018). Lancet Study Ignores Significance of Side Effects. Psych Central. Retrieved on February 19, 2020, from https://psychcentral.com/blog/lancet-study-ignores-significance-of-side-effects/