- The Washington Times - Thursday, March 23, 2006


The largest study ever conducted on treating depression has found that patients who didn’t get well with the first medicine they tried had a good chance of succeeding the second time around.

Up to one-third of those who added or changed medicines recovered from the crushing illness that is America’s top mental health problem, researchers said.

This is good news by itself, but the bigger picture is even more encouraging, doctors say. When viewed with earlier results, the new findings mean that roughly half of people who suffer from depression can get over it — not just improve their symptoms — with adequate medication.

“The goal here was to find treatments that help people to get well, not just better,” said Dr. Thomas Insel, director of the National Institute of Mental Health. “We have safe and effective treatments.”

His agency paid for the $35 million study, which involved thousands of people across the United States and has been widely praised as a real-world test of popular drugs that have received only limited testing until now.

The study found little difference among the five drugs tested — Celexa, Zoloft, Wellbutrin, Effexor and Buspar — and wasn’t designed to compare them. All proved similarly effective and relatively safe. The clear message, doctors said, was that antidepressants should be given a 6- to 12-week chance to work and that if one doesn’t help, another should be tried.

“It’s important not to give up if the first treatment doesn’t work fully,” or causes side effects, said one study leader, Dr. John Rush of the University of Texas Southwestern Medical Center in Dallas.

Two reports from the study were published today in the New England Journal of Medicine.

About 15 million Americans each year suffer depression, which so often recurs that doctors sometimes talk of it as an emotional cancer that is put “in remission” rather than cured.

“We’re talking about a very real public health challenge,” Dr. Insel said. “This is the leading cause of disability in Americans ages 15 to 44,” not just a case of “the blues,” he said.

Nearly two dozen antidepressants are on the market; 189 million prescriptions were filled last year alone. Evidence on their effectiveness is limited, and the government has ordered stronger warnings that some can worsen suicidal tendencies in teenagers in rare cases. The risk in adults is still being studied.

The big federal study first tested Forest Laboratories’ Celexa, a newer type of antidepressant called a selective serotonin reuptake inhibitor, or SSRI, mostly because it is an easy-to-take daily pill.

One-third of the roughly 3,000 taking the medicine recovered, though they generally took higher doses and were monitored more closely than most patients, researchers reported several months ago.

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