Posted on 03/23/2006 1:34:20 AM PST by neverdem
Some people with depression who do not recover with an initial course of antidepressant therapy can increase their chances of finding relief by trying other drug treatments, researchers are reporting today.
The study is the most extensive of people undergoing multiple treatments for depression.
The findings underscore the benefits of treatment with antidepressants and its limits. Although 20 percent to 30 percent of the patients who used follow-up regimens recovered, the rest did not.
The report is the second phase of a government-financed study that has tracked more than 2,800 depressed adults under the care of doctors or psychiatrists. In the first phase, reported in January, the researchers found that one in three patients recovered while taking Celexa, an antidepressant.
In two papers appearing today in The New England Journal of Medicine, the investigators report on a subset of those who did not recover. Those patients went on to complete a different round of treatment.
Experts said the combined recovery rate from the two phases was not certain, because hundreds of the patients who started the trial did not proceed to the second phase.
The study included no comparison group. In most studies of depression, 10 percent to 30 percent of the subjects recover spontaneously when taking placebo pills.
"The importance of this was that it focused on remission, not response, on treatments to help people get well, not just better," said Dr. Thomas R. Insel, director of the National Institute of Mental Health, which financed the study. "And these trials provide doctors and patients with extensive information to help find the best strategies."
Many of the more than 20 researchers involved in the study have consulted widely with manufacturers of antidepressants, but the authors said the companies played no role in interpreting the data or writing the papers.
(Excerpt) Read more at nytimes.com ...
The National Institute of Mental Health, i.e. your taxes, paid for this. Here's the version at the Seattle Post-Intelligencer, which doesn't appear identical to the NY Times' version, "Change in pills may help break depression." IMHO, regardless of the change in title, the Times' version has additional text. Here's the New England Journal of Medicine. I can't forget the patient who presented to the ER complaining of palpitations and feeling light-headed, who had a heart rate of about 250 beats per minute, which is abnormally fast, and who was taking three antidepressants, including at least one SSRI. When I called her shrink, he said she had to keep taking all of them. Go figure. Beware of adverse drug reactions.
Well, DUH!
Over the past decade, I have tried Zoloft, Wellbutrin, Cymbalta, and Effexor. So far, the latter has been the most, uh, effective, albeit with some unpleasent side effects. The other three either made me sick or made the condition worse.
My mil was on Paxil..and recently Cymbalta...Both were horrible.
Hey, that's no way to speak about your mother-in-law! ;-)
I was on Zyban, a form of Wellbutrin, for smoking cessation. After 36 hours, I had Parkinsonian motor responses. By 72 hours, I had the very worst vertigo imaginable. I experienced extreme nausea no matter if I was lying down, sitting up, eyes open, eyes closed.
I called the clinic and told the RN my symptoms and informed her I was going off the drug. She got hysterical, told me I had an inner ear infection and that I was to stay on the drug. I was angry, told her I had no symptoms of an inner ear infection and asked her how long this side effect would last if I stayed on the drug.
"Three to four months". (recall, she had insisted it was an ear infection).
I told her no way and asked her to inform my physician I was going to go off the med.
I ceased the Zyban and in eight hours was back to normal. After all I have read on these medications, I am firmly in the white-knuckle camp. As miserable as even an intermittant depression is and as dangerous as tobacco is, there are simply too many side effects from altering the brain chemistry with these medications. I would rather risk the depression and the cigarettes.
Exercise, exposure to sunlight via a vacation or an S.A.D. light, social interactions and keeping busy really seem to work as well, or better, for me.
Try breathing excercises. There are two techniques:
1. While lying down inhale deeply, filling your toraxic cavity starting with your belly then your lungs. Then exhale slowly, at about half the inhalation rate until all the air is exhausted. Repeat, and continue doing for five to ten minutes. Do this twice a day.
2. Every hour on the hour, looking at a watch with a seconds hand, try to perform six breaths in one minute. Inhale deeply for about three seconds, and exhale slowly for seven seconds. For one minute every hour.
You can also buy a machine called Resperate, which with sounds and a monitor teaches you to get in a breathing rythm that assists you anxiety and hypertension.
5-htp (L-5-Hydroxytryptophan)
Love it - buy it at the local GNC. Helps me better than any of the anti-depressants I tried for post-partum depression w/ no side effects. Took me 3 years to recover from Prozac!!
Life's too short to feel like S*&^!!!
I have used this technique and it does have a positive effect.
A variant, where the inhalation is through the nose until the lungs are completely filled and the exhalation is through the mouth, slow, lips pursed like blowing through a straw until one is forced to again inhale, about eight seconds, is also effective for controlling pain/discomfort. Controlled breathing also seems to help me with foregoing a cigarette.
I tried Zoloft - it made me twitchy and queasy. I tried Wellbutrin - it made me VERY unpleasant. Now I'm on Effexor, and I feel great! (Except for that particular side effect, which I'm sure is the same one you're referencing.)
read later
I have fought depression my entire life. I am 56 years old. Nothing seemed to work for me. About 5 years ago my doctor put me on one of the older drugs called Amitriptyline which is the generic for Elavil.
Within two weeks the depression lifted and I was able to cope with life and was happy for the first time in many years.
There were a couple of side effects. For the first month I experienced dry mouth and had a hard time waking uo in the morning.
My doctor then had me take the Amitriptyline at night to get a good nights sleep and had me take 20mg of Ritalin when I got up in the morning.
The Ritilan helps me stay positive in the morning and allows me to get started with my day. Then there is a snowball effect. As I complete more tasks, I get even more energy that allows me to accomplish more than I have ever accomplished in the past.
I now have a tremendous amount of energy. I have built a business, stopped smoking and drinking and have lost 60 pounds.
The only times I get down now is at Christmas and when summer turns to fall.
My late wife went on zoloft in 2003 as a precaution after brain surgery. Turns out that zoloft causes mania in a small number of people (.4%). So after about two months on it she went manic big time.
Then they prescribed ativan to counteract the mania. Turns out that ativan causes severe depression in something like .04% of people who take it. So after about 1 month of ativan she went suicidally depressed
Rather than examine where the depression was coming from they simply increased the zoloft to match the ativan. Idiots.
She stayed balanced for a while and then went off into bipolar hell, oscillating between mania and depression. She died Sept 20th of a seizure (oddly enough related to the surgery but not to the drugs). Eleven different MD's looked at her during this time and none of them caught the drug interaction. I did when I lookd up the drugs out of desperation.
If you are ever prescribed these drugs. Make certain you need them and pay close attention to any side effects.
I'm an effexor user, and find the results to outweigh the side effects by far.
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