MSNBC reports: Meds no better than placebos for all but most severely depressed

CHICAGO – Mild, moderate and even some cases of severe depression might be better treated with alternatives to antidepressant drugs, which do not help patients much more than an inactive placebo, researchers said on Tuesday. But for those with the most severe forms of depression, the medications have significant benefit.

(Only) 2 families of anti-depressants, paroxetine (paxil) and imipramine, were studied.

The so-called placebo effect is powerful in treating depression, where people believe they are helped even though they are taking an inactive sugar pill, DeRubeis said.

My own personal experience is that depression is a very hard nut crack. I like what Peter Kramer says in Against Depression–that it should be attacked vigorously before it deepens and becomes chronic.

Don’t let articles like this one at MSNBC be an excuse not to get treatment.

At least 27 million Americans take antidepressants, nearly double the number that did in the mid-1990s, according to a study by Columbia University and University of Pennsylvania researchers reported in the Archives of General Psychiatry.

More than 164 million prescriptions for antidepressants were written in 2008, totaling nearly $10 billion in U.S. sales, according to IMS Health. Global sales were twice that.

We need more science.   I’m all in favor of science.  Prozac, not mentioned in the MSNBC article, may have an unanticipated mechanism for helping.

From the New Scientist:

At Yale University, Ronald Duman and his colleagues began to see ways of adapting the old theories to take account of the new brain findings. After all, treatment with Prozac and other antidepressants is often amazingly successful. Maybe the monoamine theory was not entirely wrong. They noticed that Prozac and some of the other drugs increased levels of a substance called brain-derived neurotrophic factor, or BDNF, in the hippocampus. BDNF was originally identified as a “growth factor” involved in the development of the nervous system, but it is now known to be important for sustaining and protecting neurons in the adult brain. Duman, along with his colleagues George Henninger and Eric Nestler, now at the University of Texas Southwestern Medical Center in Dallas, proposed a “neurotrophic theory” of depression, in which the antidepressant effects of drugs like Prozac could be attributed to the way they keep cells alive in the hippocampus.

A hard science article from the National Academy of Sciences on the pharmacology of prozac.

A short survey of depression research at Yale. When you are reading the literature you also see things like the combination of anti-depressants, when combined with talk therapy, yield the best results. Dr. Sanacara at Yale is exploring whether the meds are increasing the brains plasticity, and therefore more receptive to therapy.