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Good news in the hunt for an effective antidepressant

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Most patients with major depression who fail to see improvement with one drug will move on to another or to a combination of drugs. Many clinicians consider adverse effects when deciding which drugs to try or which combinations may be most useful. A new study published in General Hospital Psychiatry suggests one strategy may not be any better (or worse) than another.

More than 16% of US adults are diagnosed with depression. Antidepressants are a common way to treat it. Despite the popularity of drug use, according to research in both the American Journal of Psychiatry (2006) and the Annals of Internal Medicine (2008) only 30 to 50% benefit from initial antidepressant treatment. Therefore, doctors move to a second line of treatment which may mean augmenting with a second prescription or completely changing medication.

Side effects such as headaches, difficulty sleeping and sexual dysfunction are common concerns with antidepressants. Doctors have long thought that switching drugs or augmenting with a second could exacerbate these side effects. But new research says “not so much”.

“We believed the augment group would have more side effects than the switch group,” said study author Richard Hansen PhD, head of the department of pharmacy care systems at Auburn University. The researchers found that while there were differences, and that side effects like painful urination and sexual dysfunction did occur, it was not in numbers high enough to be statistically meaningful.

“This study tries to answer an important question to which there is currently no research available,” said Alan Schmetzer, MD, interim chairman of the department of psychiatry at Indiana University School of Medicine in Indianapolis. “It’s worthwhile because if we knew it was harder on patients to do the augmentation strategy, then we would first try switching all of the time.”

Source: General Hospital Psychiatry, MedicalNewsToday

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