Depression Drugs Debunked ... Again

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[vitalchoice.com]

 

Depression Drugs Debunked ... Again

 

Only patients with severe depression consistently receive substantial

relief; omega-3s yield positive brain effects and show increasing

clinical promise

 

by Craig Weatherby

-------------

Back in 2008, we reported what happened when British researchers used

Freedom of Information requests to obtain unpublished studies funded by

drug firms. The results showed that pharmaceutical corporations may have

been misleading doctors and patients for decades. After analyzing all of

the published and unpublished data, scientists at Britains University of

Hull found that for most depression patients, Prozac-type

anti-depressants produce no significant benefits compared with placebo

pills. The only exception to this rule was that minor benefits were

detected among a small group of the most severely depressed patients.

And their analysis indicated that the benefits seen in some severely

depressed patients stem from their relatively weak responses to the

placebo effect, rather than any greater efficacy of SSRIs among this

group. For that story, see Prozac-Type Drugs Proven No Better than

Placebo [

http://newsletter.vitalchoice.com/e_article001050707.cfm?x=b11,0,w

 

.. Now, the American authors of a new evidence review have also

concluded that on average, anti-depressants only benefit severely

depressed patients. New analysis echoes earlier, negative findings on

antidepressantsThis week, researchers at the University of Pennsylvania

reported what happened when they scrutinized data from previous clinical

trials (Fournier JC et al 2010). The trials they examined tested members

of the two major two classes of antidepressants: newer Prozac-type drugs

called selective serotonin re-uptake inhibitors (SSRIs) and older ones

called tricyclics. The several large trials they reviewed had tested the

effects of Paxil (an SSRI) and the tricyclic-type antidepressant drug

called imipramine. Like the two-year-old British review, the new

analysis done by researchers at the University of Pennsylvania found

that the effectiveness of both drugs varied according to the severity of

a participating patients depression. On average, only people with severe

depression showed substantial improvements. As the Pennsylvania team

wrote, The magnitude of benefit of antidepressant medication compared

with placebo increases with severity of depression symptoms and may be

minimal or nonexistent, on average, in patients with mild or moderate

symptoms. Antidepressants remain useful for someIt's also important to

note what the Pennsylvania group went on to say: For patients with very

severe depression, the benefit of medications over placebo is

substantial. (Fournier JC et al

2010) But as co-author Robert J. DeRubeis told The New York Times, The

message for patients with mild to moderate depression is, Look,

medications are always an option, but theres little evidence that they

add to other efforts to shake the depression

- whether its exercise, seeing the doctor, reading about the disorder or

going for psychotherapy. And Oregon Health and Science University

psychiatrist Erick H. Turner, M.D., told the Times, I think the study

could dampen enthusiasm for antidepressant medications a bit, and that

may be a good thing. Peoples expectations for the drugs wont be so high.

(Carey B 2010) However, we also agree with Dr. Turner's cautionary

caveat: The findings shouldnt dampen expectations so much that people

refuse to even try medication. (Carey B 2010) People with

moderate-to-severe depression should try every available aid, from

exercise and talk therapy to nutrition and ... The British and American

findings are startling, but do not mean that people with mild or

moderate symptoms shouldnt even try an antidepressant ... if all else

has failed. Although on average they got little benefit, a minority of

mildly or moderately depressed patients received more substantial relief

than the majority of their peers did. In addition, brain imaging studies

show that antidepressant drugs stimulate growth of new brain cells in

the hippocampus region shrinkage of which correlates closely with the

depth and length of a patient's depression so they may therefore at

least prevent further progression of the disease. But similar brain-cell

growth in the hippocampus is also a benefit of omega-3s from fish oil.

Omega-3s show promiseOmega-3s and SSRI drugs alike foster growth of

cells in the brains hippocampus region, and connections between

hippocampus brain cells an effect associated with reduced depression

risk and symptom severity. And in mouse studies, omega-3s and Prozac

both restore brain cells ability to take on new roles and form new

connections, which eases the symptoms of depression (Sahay A, Hen R

2008; Venna VR et al. 2009). For more on this, see Bogus Headlines

Distort Omega-3 Depression Study [

http://newsletter.vitalchoice.com/e_article001578678.cfm?x=b11,0,w

 

.. Omega-3s are also essential to the proper function of

brain-cell membranes, and studies led by NIH clinical researcher Joseph

Hibbeln, M.D., suggest that dietary omega-3s raise brain levels of the

mood-elevating neurotransmitter called serotonin (Hibbeln JR et al.

1998). This is the very same effect, by different means, through which

SSRI drugs like Prozac are thought (but not proven) to bring some of

their benefits. Three years ago, the Committee on Research on

Psychiatric Treatments of the American Psychiatric Association (APA)

reviewed the evidence then available, and concluded that people who

consume higher amounts of omega-3s from fish enjoy reduced risks of mood

disorders. (See Top Psych Panel Says Omega-3s Deter Depression, Bipolar

Disorder [

http://newsletter.vitalchoice.com/e_article000737996.cfm?x=b11,0,w

..) And as we reported last August, the results of the

largest-ever clinical trial comparing omega-3s to antidepressants

bolstered that conclusion, finding that omega-3 fish oil may

significantly benefit half of all people diagnosed with depression.

Specifically, omega-3 fish oil seemed to help the 50 percent of

depression patients who are free from diagnosed anxiety disorders about

as much as the leading class of antidepressant drugs: selective

serotonin re-uptake inhibitors (SSRIs) such as Prozac and Paxil. See

Fish Oil Rivals Antidepressants in Clinical Trial [

http://newsletter.vitalchoice.com/e_article001512671.cfm?x=bfT6hQ1,b7b1jv7h

and search our newsletter archive [

http://www.imakenews.com/eletra/go.cfm?z=vitalchoiceseafood%2C416200%2Cb1h3yfLG%\

2C231301%2CbgqSVWq

] for depression. Sources

- Fournier JC et al. Antidepressant Drug Effects and Depression

Severity: A Patient-Level Meta-analysis. JAMA. 2010;303(1):47-53.

- Carey B. Popular Drugs May Help Only Severe Depression. The New York

Times, January 6, 2010. Accessed at

http://www.imakenews.com/eletra/go.cfm?z=vitalchoiceseafood%2C416200%2Cb1h3yfLG%\

2C3716814%2CbgqSVWq