This suggests that the choice of which drug is appropriate for which patient should be made on the basis of such considerations as side effects, cost and patient preference.

“They’re all equally effective,” said Dr. David Schlager, a clinical assistant professor of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine.

“They’re interchangeable except for side effects,” he added, so psychiatrists do tend to “exploit the side-effect profile” to find suitable medications for individual patients, he added.

According to the background information in the new study, appearing in the Dec. 6 issue of Annals of Internal Medicine, some 27 million people in the United States had taken antidepressants as of 2005.

via Best Antidepressant May Depend on Patient: Study.

via Prozac Might Ease Repetitive Behaviors in Some Adults With Autism.

Open Window, Collioure by Henri Matisse

Does your antidepressant “kind of” work? If you feel better, but not good or normal, after starting a new antidepressant, you’re probably experiencing what’s known as a “partial response.” This can be very frustrating, and unfortunately many people assume that a partial response is the best they’re going to get, especially if their doctor hasn’t fully explained the possible outcomes of trying a new antidepressant. Also, a doctor that’s rushed or less than thorough may not query the patient in enough detail to realize that the response is only partial.

Fortunately, there are a few options to consider when you get a partial response to an antidepressant. All of these, except perhaps the exercise option, should be undertaken under your doctor’s care.

1. Increase dosage

In many cases, doctors will start a patient off on a low dose of an antidepressant, especially if there’s some concern about how well the patient will tolerate the medication. Most antidepressants have several possible dosage levels. Ask your doctor if it raising yours might give you a better response.

2. Augment your current antidepressant with another medication

Over the past decade or so, doctors have started augmenting antidepressant treatment with another medication. In some cases this medication is an antidepressant, and in other cases doctors will add an anti-seizure or anti-psychotic medication. The possibility of contraindication (a negative outcome when the two medications are combined) exists, so this must always be attempted under a doctor’s care.

3. Exercise

Several studies have suggested that exercise can alleviate depression. Exercise not only relieves stress, which is believed to contribute to depression, but also gives you some immediate relief due to the endorphins that exercise produces.

4. Folic Acid

Folic acid is a low-cost way to supplement your antidepressant treatment. First, folic acid appears to enhance the performance of antidepressants. Second, a lack of folic acid is believed to contribute to depression. And third, some antidepressants are believed to deplete folic acid. Please note that no studies have been done on this topic since 1988, so these hypotheses are based mostly on anecdotal evidence.

Talk to your doctor first. You want to ensure that the folic acid will not contraindicate with your antidepressant or other medication you’re taking. It’s unlikely, but better safe than sorry. In addition, your doctor needs to be apprised of anything you’re using to augment your medication treatment.

5. Try a new antidepressant

Although I’ve listed this option last, it’s not necessarily the last thing you should try. The accepted reason for switching an antidepressant is if it does not alleviate the depression at all, but if your response to the antidepressant was minimal, your doctor may feel that switching to another medication altogether is a better course.

It’s very important to remember that you have a right to complete remission from depression on your antidepressant. It’s not asking too much. This is what is supposed to happen. If your doctor makes you feel that you should be satisfied with not being suicidal anymore or with feeling somewhat better, find another doctor.

Doses of Celexa (citalopram hydrobromide) greater than 40 milligrams a day can cause changes in the electrical activity of the heart, which can lead to abnormal heart rhythms, including a potentially deadly arrhythmia known as Torsade de Pointes, according to the agency.

Patients at high risk for changes in the electrical activity of the heart include those with pre-existing heart conditions (including congestive heart failure) and those prone to low levels of potassium and magnesium in the blood, the FDA said.

via Antidepressant Tied to Dangerous Heart Rhythm: FDA.

Antidepressants such as Prozac, Paxil and Lexapro are now the third most widely prescribed group of drugs in the United States, and many people may take them for minor complaints without being fully aware of potential risks, the researchers said.

via Americans’ Use of Antidepressants On the Rise: Study.

Researchers found the increased risk for falls also applies to those who had a dosage increase of their current prescription.

“Our results identify the days following a new prescription or increased dose of a non-SSRI antidepressant as a window of time associated with a particularly high risk of falling among nursing home residents,” said study author Dr. Sarah D. Berry, a scientist at the Institute for Aging Research of Hebrew SeniorLife in Boston.

via Certain Antidepressants Linked to Falls in Nursing Homes.

Last month brought an especially high-profile debunking. In an essay in The New York Review of Books, Marcia Angell, former editor in chief of The New England Journal of Medicine, favorably entertained the premise that “psychoactive drugs are useless.” Earlier, a USA Today piece about a study done by the psychologist Robert DeRubeis had the headline, “Antidepressant lift may be all in your head,” and shortly after, a Newsweek cover piece discussed research by the psychologist Irving Kirsch arguing that the drugs were no more effective than a placebo.

via In Defense of Antidepressants – NYTimes.com.

Specifically, the researchers found that women taking fluoxetine (Prozac) and paroxetine (Paxil) were slightly more likely to give birth to babies with specific types of heart defects.

But these results do not mean the drugs are never safe in pregnancy, cautioned study author Dr. Heli Malm.

via Some small risks to antidepressants in pregnancy | Reuters.

via Combo of Paxil, Pravachol May Raise Blood Sugar.

The findings can’t prove that the painkillers, called non-steroidal anti-inflammatory drugs, or NSAIDs, stop antidepressants from working, the authors said. But the possible link is something for patients with depression – and the doctors treating them – to think about when treating pain and inflammation, researchers report in Proceedings of the National Academy of Sciences, or PNAS.

“This is certainly something that clinicians and individuals should be keeping in mind,” Jennifer Warner-Schmidt, the study’s lead author from The Rockefeller University in New York City, told Reuters Health.

via Do painkillers interfere with antidepressants? | Reuters.