Treating depression can be hit or miss (2009 article)

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Treating depression can be hit or miss, Los Angeles Times, Devon Schuyler, Aug. 3, 2009.
http://articles.latimes.com/2009/aug/03 ... ug-choice3

(page 1) "George Porter, a 47-year-old engineering librarian from La Canada Flintridge . . . cycling through at least half a dozen drugs. Many helped, but none worked completely. . . "

(page 1) " . . . A review article in the November 2008 issue of the Annals of Internal Medicine looked at more than 200 studies . . . selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft and serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Effexor and Cymbalta -- and concluded that no substantial differences existed in how well they worked. Although a more-recent review in the Lancet of the same 12 drugs concluded that certain ones worked better than others, that analysis has been criticized for reading too much into studies that are largely funded by the drugs' manufacturers. . . "

(page 2) " . . . is to look at the patient's history, because someone who has already been treated for depression will often respond to a medication that worked before. There's also a chance that someone with a family history of depression could benefit from the same drug that helped a parent or sibling. Beyond these factors, "there is not a good way to know what medication is going to be the best for your patient," said Dr. Raymond J. DePaulo Jr., a professor of psychiatry at the Johns Hopkins University School of Medicine. . . "

(page 3) " . . . Sequenced Treatment Alternatives to Relieve Depression (STAR*D) . . . a second drug from the same class is just as likely to work as one from a different class. That is, people who don't respond to one SSRI have just as good a chance of responding to a second SSRI as to an SNRI or Wellbutrin. . . found that 37% of patients went into remission after the first round of treatment, 31% after the second, 14% after the third, and 13% after the fourth. A third of patients in the study continued to struggle with depression after four cycles of treatment. . . "

(page 3) " . . . STAR*D showed that it can take as long as eight weeks for a drug to begin working and up to 12 weeks to get the full effect. Doctors don't know why the drugs take so long to work; one theory is that the increase in neurotransmitters allows neurons to adapt, grow and establish new connections over time. . . " [in other articles I've read generally 4 weeks, somewhat longer for senior citizens]

(page 4) " . . . still have treatment options. One is electroshock therapy, which works well but can cause temporary memory loss. A newer alternative, called transcranial magnetic stimulation, doesn't affect memory but may be less effective. This is the treatment that Porter turned to after his long struggle with depression. He said that he was feeling much better after a month of daily treatments five days a week at UCLA. . . "

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See also . . . Stopping antidepressants can cause side effects, Los Angeles Times, Regina Nuzzo, Aug. 3, 2009.
http://articles.latimes.com/2009/aug/03 ... ing-drugs3

yeah I will stick to what I am doing currently.....lol no electric wires or magnetic pulses in my brain please.

I’m not real crazy about electric shock treatment either! (nor even this supposedly safer magnetic pulses.)

What I mainly take from this article is the validity of the approach, okay, if a medicine isn’t working for a person (after 8 to 12 weeks, but again, from other sources I have heard 4 weeks), it’s recommended that he or she try another. And conversely, if a medication is working, either good or just okay, it’s basically recommended that a person just keep rolling with a good thing (although in other sources I have read about adding a second booster medication, sometimes lithium, to the first). And it is disappointing to find out that once someone has gone through three unsuccessful medications, the fourth has only a 13% of working. Well, I play poker (just bar poker for points these days ) and I see 10% and even 5% come in all the time.

Now, one thing the article doesn’t talk about is diet, which I understand can be a real game-changer for some people, but not for others, and unpredictably so with who it works for and who it doesn’t. And to a lesser extent this is probably also true for Seasonal Affective Disorder and full-spectrum lighting. It’s just very hard to predict in advance.

Please Note: I AM NOT A DOCTOR. again, a pretty good guy , I can look some stuff up and ask some good questions, but that is far, far from being a doctor.

Depending on the condition being diagnosed can really hold people back. They identify with the diagnosis. I have a.d.d or I have ocd. Sometimes it's needed other times it can get in peoples own way of getting better.