Popular Drugs (Paxil, imipramine) May Help Only Severe Depression

[HuckleB]

http://www.nytimes.com/2010/01/06/health/views/06depress.html?em

"Some widely prescribed drugs for depression provide relief in extreme cases but are no more effective than placebo pills for most patients, according to a new analysis released Tuesday.

The findings could help settle a longstanding debate about antidepressants. While the study does not imply that the drugs are worthless for anyone with moderate to serious depression — many such people do seem to benefit — it does provide one likely explanation for the sharp disagreement among experts about the drugs’ overall effectiveness.

Taken together, previous studies have painted a confusing picture. On one hand, industry-supported trials have generally found that the drugs sharply reduce symptoms. On the other, many studies that were not initially published, or were buried, showed no significant benefits compared with placebos.

The new report, appearing in The Journal of the American Medical Association, reviews data from previous trials on two types of drugs and finds that their effectiveness varies according to the severity of the depression being treated.

..."

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This study is interesting, but actually quite preliminary, IMO. It's quite difficult to generalize the findings from Paxil and imipramine to all antidepressants, despite what "the experts" are reported have said, IMO. The headline does seem a bit generalized, considering the limits of the study. However, further reviews on other SSRIs, SNRIs etc... does seem warranted.

On the other hand, we are given information that depression is under treated in the US. See http://www.sciencedaily.com/releases/2010/01/100104161746.htm

[GreenPartyVoter]

1. I have found that to be the case for my bipolar depression. My baseline is

apathetic and somewhat depressed. I haven't yet found anything that really lifts that very well. But when I drop into a deep depression, then the meds help in the sense that they get me back to just apathetic.

[T Wolf]

2. Hey. Paxil saved my life. I guess that means I was REALLY depressed. Now, if I could only

find my anger-management meds....

[HuckleB]

10. Anger management meds sound like strong stuff.

[Brickbat]

3. I had what I assume was mild-to-moderate depression, and Paxil wiped it out for me. I know it's

seen by many as a boogeyman drug, but I'm grateful for it.

[HuckleB]

7. It's worked well for many people, but some have had difficulty with it.

Coming off Paxil may be more of an issue for some than with other SSRIs.

[robinlynne]

4. I also disagree with these findings from what I know. However, placebos can actually

help a lot of people!!! Especially when you are talking about depression. placebos provide hope, which in many cases helps the "curing" process. So perhaps what the article did not say is placebos work almost as well as the real thing, which does not mean the anti-depressants do not work.

[mopinko]

11. placebos generally peter out.

they help for a while, in some cases, but the effect is usually limited to 6 months or so.

[robinlynne]

12. and the study was for how long?

[mattvermont]

5. the exception to this poorly done study

is with 'dysthymia', a chronic low level depression. This is the depression I know and Paxil
has been a lifesaver. I think that the study merely states that for people who are occasionally sad
or depressed are not helped because such states are normal. Dysthymia, on the other hand is helped by SSRI's
because there is an abnormal neurotransmitter imbalance.

In short, if you are not clinically depressed, these medicines do not help....DUH

[Thirtieschild]

6. I also suffer from dysthymia and was helped enormously by Zoloft.

My dysthymia is very, very different from Mr. 30's episodes of severe depression. He started Elavil in the 70s, now takes Effexor. As I understand it, because Effexor-type drugs combine the effects of Elavil and the effects of the SSRIs, they are better for those with major depression. Anti-depressants have been a Godsend for both my dysthymia and his major depression. Life was pretty grim before Elavil.

[HuckleB]

8. There are always exceptions, and many of them are wonderful!

I don't quite understand how you have determined that this study is "poorly done," however.

Can you explain?

:shrug:

[Ocracoker16]

9. Agree that study is preiminary

They only studied Paxil and imipramine. So they studied an SSRI and a tricyclic. I can think of a bunch of antidepressants that don't fit into either category. I am thinking of Effexor, Cymbalta, Wellbutrin, Remeron, and MAOI's. Furthermore, I don't think that it makes sense to generalize the findings on Paxil to the other SSRI's without some numbers to back it up.