Thursday, October 7, 2010

Depression treatments research

I just ran across this interesting research on the effectiveness and popularity of depression treatments.  Now that they have published the data the popularity of the treatments should change significantly.

I don't particularly care about the popularity side of the study.  That's a little interesting.  It's mostly sad that so many people have been focusing on ineffective treatments.

According to this research, these are the most effective treatments for depression:
  • Exercise (far and away the most effective treatment)
  • Talk therapy
  • SSRIs (Selective Serotonin Reuptake Inhibitor)
  • Meditation
  • Spending time with pets
  • Adequate sleep
  • Cognitive Behavioral therapy
  • Psychotherapy
  • Light therapy

And the most ineffective treatment list:
  • Caffeine
  • Effexor
  • Trazodone
  • Paxil
  • St. John's Wort
  • Fish oil
  • Depakote
  • Magnesium
  • Flax seed oil
  • Effexor XR
  • Cannabis
  • Cold Shower
  • Lexapro
  • Prozac
  • Chiropractic care
  • Tryptophan
  • Vitamin B
There are two dozen other treatments that fall between those two lists.  Hit the article and mouse-over the blue dots to see the whole list and find your favorite treatment.

That wikipedia article I linked on SSRIs is quite interesting.  It includes an enlightening quote from a major research study:
"The magnitude of benefit of antidepressant medication compared with placebo ... may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial."
Several of the drugs listed as ineffective are SSRIs.  How can they be both effective and ineffective?  Read the quote again.  Ineffective against mild or moderate symptoms, but effective against very severe depression.

So, my summary of the treatment scores is that successfully treating mild to moderate depression depends upon what you do, much much more than on what you swallow.  But very severe depression may respond to certain drug treatments.

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