Posted by Racer on July 18, 2004, at 21:17:37
In reply to Are SSRI's really the best?, posted by 1980Monroe on July 18, 2004, at 18:48:56
First of all, what do you mean by "best"? If you mean are they the most effective against depression, probably not. What they are is the *safest* class of anti-depressant, with the lowest incidence of serious side effects. That's why they're the first line drugs for depression for most doctors.
Someone here will have more up to date and specific information, but the sense that I've gotten from looking at studies is that most of the different classes are pretty comparable in terms of effectiveness, with a fair number of people saying that MAOIs are the closest to a miracle drug out there. The problem is that MAOIs and TCAs can be lethal in overdose, have some pretty significant side effects, and can be disruptive for patients, leading to compliance issues. MAOIs in particular involve a pretty major commitment on the part of patients in terms of dietary restrictions, and failure to comply can be quite dangerous.
When you're asking about issues like "best", "strongest", "mildest", etc, in terms of antidepressants, there's no easy, set answer. This is a great illustration of Wittgenstein's "Word Games" -- it depends on the boundaries you set for the meaning. If you mean "best" as in working the best for the largest number of people, it might be SSRIs, for instance, because they are prescribed for larger numbers of people overall. If you mean which works best for the highest percentage of people taking them, it might be MAOIs simply because they've been on the market the longest. The more specific the questions you ask, the more informative the answers you will get.
Cheers
poster:Racer
thread:367485
URL: http://www.dr-bob.org/babble/20040714/msgs/367560.html