Despite publications and media attention to the contrary, those of us in clinical practice, as well as our patients, have no doubt that antidepressants work. Confusion may arise because of the nature of FDA Registration clinical trials and what they are designed to achieve, and the placebo effect. Now, a large-scale analysis, published in the rigorously peer-reviewed Archives of General Psychiatry, has strongly validated the experience of patients and clinicians — that antidepressants work. The researchers reviewed a large number of trials of two popular modern atidepressants, fluoxetine (Prozac) and venlafaxine (Effexor) which included 9,182 patients. Extremely robust and clinically relevant improvements were seen, including on measures of both response and remission. In addition, the benefit of antidepressants was seen regardless of the severity of depression, which ranged from mild to severe. Every patient is unique, and despite overall similarities in response rates in clinical trials of antidepressants, a thorough assessment of patient characteristics, including symptoms that might be co-existing with depression, like anxiety or lack of motivation, and the unique features of particular antidepressants, can determine the best option for each individual patient.
Best Regards, Dr. Ranen
Neal G. Ranen, M.D., Psychiatrist Baltimore County