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Radio Shows February 9, 2008
Depression is debilitating and surprisingly common. Scientists have found that 5 percent of the people in a large survey reported symptoms of depression during the previous year. Nearly 13 percent of Americans experience depression at some point during their lives.
The big question is how to treat depression? It’s hard to get a good picture of the effectiveness of antidepressants from the published medical literature, because many studies that show little or no benefit don’t get published. Dr. Erick Turner explains how unpublished studies may skew medical opinion.
Dr. David Mischoulon discusses the pros and cons of antidepressant medication and many alternative treatments for this devastating mental disorder.
Guests: David Mischoulon, MD, PhD, is the Director of Research, Depression Clinical and Research Program, at the Massachusetts General Hospital Department of Psychiatry. He is also an Assistant Professor of Psychiatry at the Harvard Medical School. He is currently working on the second edition of his book, Natural Remedies for Psychiatric Disorders: Considering the Alternatives. (Photo is of Dr. Mischoulon.)
Erick Turner, M.D. is Assistant Professor in the Department of Psychiatry at Oregon Health & Science University (OHSU) and in the Department of Pharmacology & Physiology. He is the Medical Director of the Portland VA Medical Center Mood Disorders Program, where he acts as site principal investigator (PI) on several multicenter clinical drug trials. His article, "Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy," was published in the New England Journal of Medicine, Jan. 17, 2008.
Tags: antidepressants, depression, Effexor, Lexapro, Prozac, St. John's wort, Zoloft
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Reader Comments
I have been on Effexor 75xr for a number of years now (7?) to treat mild depression (disthymia?). At the time my Dr. prescribed the treatment he said I should expect to be on it for the rest of my life. I found this odd considering how our understanding of the brain and various related disorders is really in its infancy. He said that I could expect to have recurring bouts of depression and if left untreated, they would get worse with time. However, I do wonder what prolonged use of the drug will have (is having) on my brain. Your thoughts?
Posted by: Frank Myka | February 8, 2008 9:30 AM
I've taken antidepressants for quite awhile and find that most have some sort of side effect. I would be very interested in finding an alternative medicine that might not have the side effects associated with traditional medicines.
Posted by: ja | February 8, 2008 12:50 PM
I had very good results with an SSRI type drug for depression. I had not even known I was depressed as I did not feel sad. I was seeking treatment for debilitating fatigue. However, except for not feeling particularly glum, all of my symptoms indicated depression (menopause probably had something to do with putting me in a chemical imbalance). Anyway, I went through several SSRIs before finding one that had tolerable side effects (Wellbutrin XL in my case).
Now I feel great. It is like I got my life back. I have a friend who is chronically depressed (runs in her family) and had tried some SSRIs, but discontinued because of side effects. When I told her it took me several drugs to find one that worked, and that one really did work great, she went back to her doctor and gave meds a try again (she was very inspired when I said my meds made me no longer confused).
She finally found a med that worked! In fact, she said her biggest fear in life is that something might happen that will cause her to have to stop taking her SSRIs. So, there are two stories of depression medication working (perhaps the one thing in common in both our cases is that we were not depressed because of life circumstances, it was more an internal physical condition).
Posted by: Terry | February 8, 2008 6:10 PM
I read in NEJM recently the case of an 82yo F with long hx of recurrent MDD refractory to tx. She had tried citalopram, duloxetine, and combinations with the addition of olanzapin. The decision was made to use ECT on this patient in combination with continuing citalopram. Please comment on when it is appropriate to use ECT; what ages groups; safety/efficacy, etc.
Posted by: Todd B | February 9, 2008 7:29 AM
As prevalent as "Serotonin Syndrome" is, this should have been mentioned on the program. Many of us have the problem of many side-effects -- some serious -- when our serotonin level is raised.
I went through hell with many antidepressants until I found this was my problem. I hope you will do another program on this topic soon.
Posted by: June Russell | February 9, 2008 10:00 AM
I suffered terrible depression for 11 years. I used amitripline and Paxil and had side effects. One day I walked into A Wild Oats store and asked the person in charge of the herbal remedies what would help me with my illness. She suggested Eskimo 3 fish oil. I tried the recommended dosage and I received immediate relief. Eskimo 3 is very expensive, but comes in smaller doses than other brands of fish oil.
I looked around and found The Kirkland brand from Costco, the best buy, and use 1000mg in the morning and 1000mg in the evening to cure me of my depression. If I get to feeling down during the day, I take a smaller dose of Eskimo3 to pick me up.
I tell my doctors this, and they seemed suprised it helped me so well. My last doctor dit start checking me for lead and Vit B12. When I started this I didn't think it would hurt anyway because the fish oil will also help my heart. I have been on Fish Oil for 4 years now and no more paxil.
Posted by: DK | February 11, 2008 9:14 PM
I have been on mood stabilizers and antidepressants for over 22 years. I have seen no information about long-term side effects. We are part of the first generation to take these medications for a long time.
Posted by: JJBR | February 15, 2008 3:47 PM
I started on Effexor 75 mg. After a few months, my Dr. raised it to 150. I am still having some depression. Not wanting to get out of bed when I have had plenty of sleep... 8 to 9 hours. I fall back to sleep. My Dr. just raised it to 225 mg. This seemed like a lot, but I really don't know. Before this, other doctors have had me on different mood stabilizers that did not agree with me at all. What do you think? AMK
Posted by: AMK | February 17, 2008 12:58 AM