Friday, November 24, 2017 22:10

How To Use Antidepressants

Posted by on Tuesday, September 22, 2009, 18:27
This news item was posted in Depression category and has 0 Comments so far.

So how does a psychiatrist decide which antidepressant to use? As is true with most things in life, the past predicts the future. If you have responded well to a particular antidepressant in the past, you are likely to respond well again this time around.

Another guide is a family history if a particular medication has been helpful top a family member, it is likely to be helpful to you. Lacking such information, the choice of antidepressant generally depends on tailoring the side effect profile to your symptoms, lifestyle, and personal preferences. One person’s side effect is another person’s godsend.

For example, some antidepressant are particularly sedating. This side effect is a plus for someone who drives a truck for a living or has to get up early for work. In general, the older antidepressants are more likely to cause side effects that are poorly tolerated.

Reading this you might conclude that we think medication is necessary for everyone with depression. On the contrary, antidepressant medications are probably overused. Three of the top ten best selling medications in the United States are antidepressants: Prozac, Zoloft, and Paxil.

Interestingly, most of the prescribing is done by primary care physicians and not by psychiatrist. While antidepressants have been used more and more widely, they have probably  been used less and less wisely, often for individuals who do not relay need them.

It has long been recognized that only past of the healing power of antidepressant can be attributed to the medication itself. The passage of the time , positive expectations, and the supportive role of the person administering the medication all play a critical role in treatment response.

For this reason, treatment studies of depression almost always include a so called “placebo group” people who are given a dummy pill instead of active medication. In a typical drug study, around 60-70 percent of those who receive the tested antidepressant have a significant improvement, as compared to about 30 to 40 percent of those on the placebo.

The catch is trying to apply this information in clinical practice is that there is no way to know in advance which half of the group will get better if given only active medication.Moreover, since it is unethical to device patients about what they are being prescribed, there is no practical way to patients about what they being prescribed, there is no practical way to ‘try out” placebo.

Being forthcoming as to the true nature of the pill would likely compromise its effectiveness since the belief that one is talking an active medication is probably an important element.

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