The Efficacy Dilemma of Antidepressants – Depression, Essay Group 6
Depression being an affective mood disorder is a serious global public health issue with over 350 million sufferers worldwide8,10,11. Although it is described with feelings of low mood, inadequacy, guilt, low self-worth, loss of motivation, interest, pleasure and concentration; it is also associated with a functional deficit of the monoamine transmitters (serotonin and noradrenaline) in certain brain regions such as amygdala, hippocampus and prefrontal cortex6,10. It can also induce biological symptoms like retardation of thought and action as well as sleep disturbances, loss of appetite and libido and if left untreated, it can eventually lead to disability8,11. Therefore, the pharmacotherapy plays a crucial role in the treatment of depression.
A study that had been done in the out-patient department of Psychiatry in a tertiary care teaching hospital in Eastern India focused on the prescribing patterns of antidepressants as well as their efficacy evaluation in depressed patients8. The types of medication used for the study were Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclic Antidepressants (TCAs), Serotonin Norepinephrine/Noradrenaline Reuptake Inhibitors and Norepinephrine Dopamine Reuptake Inhibitors (SNRIs and NDRIs) which all belong to a class called monoamine uptake inhibitors. In the study, a total number of 160 people were included regardless of their age, sex, physical and mental
Although this is a fake way to treat depression, it does actually help the disorder depending on the person. Still, this effect is a huge hole in the credibility of antidepressants. On the bright side, there are some people who have had good cases involving only antidepressants. In other words, “Make no mistake: For many people, antidepressants do work. In fact, they can be life-saving.” (Web MD) Mainly stating that for some users antidepressants are all they need. Still it all comes down to the user or person, and what works the best on them personally. With it’s many flaws the other argument does make it’s vital points on the subject.
Cuijpers (2017) identifies that over the last 40 years there have been approximately 500 randomized trials looking at the efficacy of treating depression with psychological methods. The studies chosen provide insight into the lack of efficacy of antidepressant medication therapy, as well as the effectiveness of psychological therapies. The evidence provided in the studies appears to support one another.
The research critically analyses the desired effects of the depression and the antidepressants available for the depressions. Depression symptoms are commonly seen among people of various ages. There are some of the antidepressants that are initially recommended for overcoming the issues of depression. Some of the well-known methods have been used by many of the known researchers regarding the topic of depression. Proper evaluation of the research methodology about depressions will help in the better understanding of the mental state of the people suffering from the diseases of depression. The evaluation of the two of the research papers mentioned above highlights the fact that research between a certain numbers of the people will help to evaluate
Once a practitioner has a strong understanding about MDD diagnostic criteria, prevalence, etiology, and prognosis, he or she should then strive to understand recommended MDD treatment modalities. The use of antidepressant medication (ADM), has been a highly regarded treatment for depression. In addition, cognitive-based approaches have also seen positive results. Therefore, Hollon et al. (2014) examined the effects of cognitive therapy (CT) combined with ADM, as opposed to ADM alone, on the treatment of individuals with MDD. Hollon et al. (2014) recruited 452 adults with chronic or recurrent MDD for this study. Patients were randomly assigned to the CT and ADM condition or to the ADM only condition (Hollon et al., 2014). Hollon et al. (2014) also stated that treatment lasted as long as 42 months. Hollon et al. (2014) found that CT combined with ADM significantly improved the rate of recovery when compared to the ADM alone, but only if the patients had severe MDD. The effect was not significant for individuals with mild and/or moderate depression. Therefore, Hollon et al. (2014) argued that ADM combined with CT will improve recovery rates for individuals with severe MDD.
Antidepressants are a powerful way for people who suffer from severe depression and anxiety to stay in control of their lives. Unfortunately, many people who take antidepressants also have problems with illicit drug use. And while attending drug rehabilitation is the most effective way to regain control of your life, the question of whether or not you can take your antidepressants while you're there is surprisingly complex.
Does cognitive-behavioral therapy work just as well as antidepressants when treating depression? How we perceive our depression is what helps to determine the type of treatment necessary. Antidepressants treat the common symptoms of depression rather than the condition while therapy helps change the thought process so the disease is cured in the end. Many studies are done to provide necessary information to what the answer to this question should be. The following articles provided studies that explained the effects of treatment with medication, with therapy, or a combination of both.
Selective serotonin reuptake inhibitors are utilized for their ability to reversibly block the reuptake of serotonin in the synaptic cleft. In order to understand the importance of these drugs, it is crucial to review the various regions of the brains that are influenced by serotonin and the implications of impaired functioning. A dysfunction in the hypothalamus region of the brain might lead to weight or appetite changes. Sleep disturbances are characterized by a dysfunction in the hypothalamus as well, along with the thalamus, basal forebrain, and prefrontal cortex. Thoughts of suicide and perceived feelings of guilt or worthlessness are associated with a dysfunction in the brain regions connected to our emotional well-being, including the amygdala, ventromedial prefrontal cortex, and orbitofrontal cortex. Psychomotor agitation is linked
Herng wad Sworth Longfellow once said that “Every man has his secret sorrows which the world knows not and often times we call a man cold when he is only sad”.Unfortuately, over 50% people are depressed due to circumstances happening around them. Consequently most of them takes these drug called antidepressant which is used to relieve or prevent depression. However, I strongly agree those antidepressants are dangers to human health and society.
Other clinical studies have implicated fluoxetine’s effects on serotonin neurotransmitters, based on the fact that serotonin is synthesized from the essential amino acid tryptophan. Patients taking fluoxetine who were in remission from major depression were given a special diet which was tryptophan-free. This rapidly decreased plasma serotonin levels, and after a short period of time (as little as 30 minutes) many of the patients began to have signs of specific depressive symptoms. Later, the reappearance of more general depressive symptoms were observed in a majority of the patients. Thus it was shown that fluoxetine has a profound effect on the neurotransmitter serotonin, and decreased
three groups.Monoamine oxidase inhibitor (MAOI) medicines block the monoamine oxidase enzyme (MAO) from destroying monoamine neurotransmitters, which allows them to accumulate, alleviating depression. Serotonin selective reuptake inhibitor (SSRI) medications block the serotonin reuptake pump, allowing the serotonin neurotransmitter to remain and accumulate in the receptor for longer. Speaking of serotonin specifically, depression has been related to a deficiency of the 5-hydroxytryptamine (serotonin) neurotransmitter as evidenced by the concentrations of the
According to the Centers for Disease Control, eleven percent of Americans, ages 12 years and over took antidepressant medication from 2005-2008 (Pratt, 2011). Antidepressants are used to treat conditions such as major depressive disorder, anxiety disorders, insomnia, obsessive compulsive disorder, eating disorders and many other mental illnesses. Antidepressants are also prescribed to treat medical conditions such as, rheumatoid arthritis, fibromyalgia, migraines and pre-menstrual tension. General practioners or psychiatrists can prescribe antidepressants to patients at any age.
The linkage of serotonin to depression has been known for the past five years. From numerous studies, the most concrete evidence of this connection is the decreased concentration of serotonin metabolites like 5-HIAA (5-hydroxyindole acetic acid) in the cerebrospinal fluid and brain tissues of depressed people. If depression, as suggested, is a result of decreased levels of serotonin in the brain, pharmaceutical agents that can reverse this effect should be helpful in treating depressed patients. Therefore, the primary targets of various antidepressant medications are serotonin transports of the brain. Since serotonin is activated when released by neurons into the synapse, antidepressants function at the synapse to enhance serotonin activity. Normally, serotonin's actions in the synapse are terminated by its being taken back into the neuron then releases it at which point "it is either recycled for reuse as a transmitter or broken down into its metabolic by products and transported out of the brain." As a result, antidepressants work to increase serotonin levels at the synapse by blocking serotonin reuptake (2).
(3) While successful drug therapies which act on neurotransmitters in the brain imply that depression is a neurobiological condition (4), the fact that such medications do not help about 20 percent of depression-sufferers seems to show that not all depression is due to such imbalances. Rather, depression is not caused by one single factor; it is most often caused by many different things. Genetics, biochemical factors, medicines and alcohol, developmental and other external factors, and relationships, marriage and children all have effect on the development of clinical depression. (5) The strongest hypotheses on the pathways to depression are in decreases in the activity of specific neurotransmitters, or the overactivity of certain hormonal systems. (3)
This article deals with overuse of antidepressants in Canada and talks specifically about selective serotonin reuptake inhibitors (SSRIs) and how there is proof that suggests this drug to be less effective than what is published in medical journals.
There are a variety of treatments to treat severe depressive episode such as antidepressant medications such as Sertaline hydrochloride 100mg daily-PO and Venlafaxine 37.5mg- PO- nocte showed effect in treating severe depressive episodes by increasing available serotonin leading to improved or elevated low depressed mood. Mrs. Brown’s mood slightly improved after taking medications as per charted (O’Brain, 2013). Antipsychotic drugs such as Quetiapine 12.5- PO- mane/nocte showed effect in treating severe depression by reducing the intensity of negative perceptions as they work on the dopamine receptors found in the brain (O’Brain, 2013).