Antidepressants are psychiatric medicines used to alleviate mood disorders. Antidepressants work on the brain in a variety of ways, different antidepressants target different areas of the brain  Tricyclic antidepressants were one of the first major antidepressants introduced in the late 1950’s, and were later replaced by selective serotonin reuptake inhitors, or SSRIs. SSRIs  increase the amount of serotonin available to bind to brain’s receptors; Prozac, Zolof, and Paxil are some of today’s most popular SSRI antidepressant drugs.  SNRIs, serotonin-norepinephrine reuptake inhibitors, such as Effexor and Wellbutrin, work by increasing the levels of the neurotransmitters serotonin and norepinephrine in the brain, which plays a role in one’s mood.  

Lately there has been controversy surrounding the overall success of antidepressants. Some researchers argue that people are being too over-medicated,  that antidepressants are not extremely beneficial in patients with mild depression. The placebo effect refers to a patient taking  a sugar pill and reporting  feeling better, simply because they took a pill they were told would improve their condition. In reality, the patient ingested a sugar pill and it was their change in thought that led their condition to improve.

Patient volunteers are told they will receive either the drug or a placebo, and neither the scientist nor the patient knows who is getting the sugar pill as opposed to the actual drug. Most volunteers want to get the actual drug, and several weeks into the clinical trial users know they are on the real drug when they experience side effects.  Some studies have shown that the worse the side effects, the more effective the patient believes the drug is, heightening expectations.

Newsweek argues that the belief in the power of a medical treatment can be self fulfilling, aka the placebo effect.

However, drug advocates argue that the FDA would not have approved ineffective drugs for millions of people to take. The FDA requires two clinical trials to prove that a drug is more effective than the placebo. In patient-doctor relationships, doctors personally monitor and see the positive effect antidepressants have on a patient’s mental state.

In an analysis of six experiments where depressed patients received a placebo or active drug, the true drug effect (the drug’s effect in addition to the placebo effect) was found to be “nonexistent to negligible” in patients with mild and moderate depression.  In patients with very severe symptoms, there was a statistically significant drug benefit.

Certainly, antidepressants have helped tens of millions of people, and people on antidepressants should not discontinue taking their medication. However, antidepressants may not be the best first choice for patients with mild depression.

Psychotherapy has shown to be extremely effective in treating patients with depression, depression ranging from mild to moderate to severe. For some patients, psychotherapy in addition to antidepressant medication works even better. Each individual experiences depression differently, and psychotherapy is particularly tailored to each person’s individual issues.

In the U.S., many patients with depression are treated by their primary care physicians, not psychiatrists.  If you are experiencing depression or any other mental problem, it is important to see a therapist or psychiatrist over a primary care physician. Therapists are able to truly individualize your treatment, and give your mental health the utmost attention.  Apex Behavioral Health can provide you with psychotherapy and psychiatry. Apex is specialized in mental health, all of our staff is certified and qualified. Please don’t hesitate to seek out a doctor or therapist - depression symptoms can get better.

The Newsweek article can be found here: http://www.newsweek.com/id/232781/page/1