Posted by Krissy P on March 24, 2003, at 1:10:40
In reply to Antidepressants can Actually Worsen Depression, posted by juanantoniod on March 23, 2003, at 23:58:22
thanks for this. I am beginning to wonder then what do we do for our depression?
A great poster said exercise, exercise, exercise and I am going to do it. I have no other choice. I had a really down day today and I am going to talk to my pdco about re evaluating my med cocktail. I hate this.
sorry to vent but wanted to thank you
kristen
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> Okay, besides reading that AD studies don't recruit depressed patients -- isn't that scary? What about this article? Does anyone else here find particular distress in this theory -- that ADs can actually worsen depression?
>
> Journal of Clinical Psychiatry
> February 2003 (Volume 64, Number 2)
> Can Long-Term Treatment With Antidepressant Drugs Worsen the Course of Depression?
> Fava GA
> Journal of Clinical Psychiatry. 2003;64(2):123-133
> Currently, antidepressant medications are one of the most widely prescribed pharmacologic agents in the United States. Their effectiveness in treating the acute symptoms of depression are unquestioned. However, the effect of these medications on the long-term course of depressive illnesses remain a cause of concern. The author reviewed the literature, conducting a MEDLINE search utilizing the keywords tolerance, sensitization, antidepressant agents, and switching. Studies he examined included those that are suggestive of difficulties with utilization of antidepressant medications in the long-term; ones with a poor long-term outcome of major depressive disorders treated by antidepressant medications; ones that showed the paradoxic effects of antidepressant medications, including an increase in the depressive symptoms in patients with anxiety disorders who are treated for anxiety but who did not manifest initial depressive symptoms; and those that revealed the phenomenon of antidepressant-induced switching in bipolar disorder. He then examined the possibility of tolerance and resistance to antidepressant drugs over time and described the oppositional model of tolerance as a possible pathophysiologic mechanism. In this theory, the continued use of antidepressant medications in patients may recruit processes that appear to oppose the initial acute effects of these medications. This process, according to the author, may explain the phenomenon of tolerance in some patients as well as possibly pushing the depressive illness to a more severe and unresponsive course to treatment. He then proposed how this theory of antidepressant medications causing sensitization can be researched, and provided several models to pursue. The author concluded that further research, although difficult, is needed in order to better understand the long-term effects of antidepressant medications on the course of depressive illnesses.
poster:Krissy P
thread:212055
URL: http://www.dr-bob.org/babble/20030319/msgs/212092.html