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| Find us again! Moodletter provides information, hope and help to people living with depression, anxiety or bipolar disorder and those who care for them. ©2006-2011 Deborah Wiig
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When
antidepressants don't work: Try, try again? |
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Have
you read these?
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| Medications
may cure depression, but it may take several attempts to find the right
one. How many will you have to try?
Major depression affects almost 15 million American adults each year. Two-thirds of them can eventually find relief, according to a federal study, if they are willing to keep trying medications until they find one that works for them. But, the odds of beating the depression diminish with every additional treatment strategy needed. The seven-year study by the National Institute of Mental Health, called StarD (Sequenced Treatment Alternatives to Relieve Depression), tracked 4,000 people diagnosed with chronic depression to determine which treatments brought complete remission. Here how the study worked Participants proceeded through successive treatment stages, adding and switching meds as needed. First
try: Relief for 33% Second
try: Relief for 25%
Those who did not become symptom-free, or who experienced intolerable side effects, could choose to continue to level 3. Third
try: Relief for 12-20% In the level 3 switch
group, 12 to 20 percent of participants became symptom-free, and the two
medications used fared about equally well.
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Fourth try: Relief
for 7-10%
The STAR*D study showed that about half of participants became symptom-free after two treatment levels. Over the course of all four treatment levels, almost 70 percent of those who did not withdraw from the study became symptom-free. However, the rate at which participants withdrew from the trial rose with each level-21 percent withdrew after level 1, 30 percent withdrew after level 2 and 42 percent withdrew after level 3. Like other medical illnesses, depression affects different people in different ways, but a wide range of effective treatments exist. People with depression should not give up if their initial treatment attempts do not result in full benefits. They should continue to work with their doctors to find the best treatment strategy. Doctors should provide medication at optimal doses, be aware of and offer treatment choices, and diligently monitor patients during and following treatment. While some people may experience benefits in the first six weeks of a treatment, full benefits may not be realized until 10 or 12 weeks have passed. National Institute of Mental Health StarD Related articles Page updated April 1, 2007 |
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In
the add-on group, about one-third of participants became symptom-free,
with somewhat better results from bupropion.
Those
in the add-on group received either lithium - a mood stabilizer used to
treat bipolar disorder - or triiodothyronine (T3) - a medication used
to treat thyroid conditions - to add to the medication they were already
taking. These medications were chosen because they have been shown to
boost the effectiveness of antidepressant medications. About 20 percent
of participants became symptom-free, with little difference between the
two treatments. However, lithium caused more problem side effects.