Ya Right-Studies-Antidepressants Work and Don't Boost Suicide Risk

[Guest guest]

Happy New Year everyone

With the New Year comes more new spin from the drug pushers.

http://www.forbes.com/lifestyle/health/feeds/hscout/2006/01/01/hscout529949.html

Health

Antidepressants Work and Don't Boost Suicide Risk: Studies

SUNDAY, Jan. 1 (HealthDay News) -- Contrary to what has been feared,

the antidepressants known as serotonin reuptake inhibitors (SSRIs) are

initially effective in as many as one-third of depressed patients and

don't appear to increase the risk of suicide, two new studies claim.

The reports, both of which were funded by the National Institute of

Mental Health, appear in the January issue of the American Journal of

Psychiatry.

The suicide findings seem to challenge a 2004 advisory by the U.S.

Food and Drug Administration that warned that suicidal behavior may

increase after treatment with SSRIs. However, the study did find that

suicide attempts were higher among teens than adults, a finding borne

out by other research.

The first report is based on early data from the Sequenced Treatment

Alternatives to Relieve Depression (STAR*D) trial, the largest study

of its kind. This research looked at the benefits of antidepressants

in " real world " settings.

" About a third of the patients achieved remission, " said lead

researcher Dr. Madhukar Trivedi, director of the Mood Disorders

Research Program and Clinic at the University of Texas Southwestern

Medical Center, in Dallas. " An additional 10 to 15 percent achieved a

response. "

The object of the study was to provide physicians with guidelines for

treating depression, Trivedi said. " The goal is to have patients

provided with an adequate dose of medication for an adequate time, " he

explained. " Treatment would be tailored for each individual patient to

get the most benefit from treatment. "

For the study, researchers looked at the results of prescribing the

SSRI Celexa to 2,876 patients with major depression. These patients

also had other physical and psychological problems. The researchers

found that about a third of the patients had their depression cured

during the first 12 weeks of treatment.

In addition, another 10 percent to 15 percent of the patients showed a

response to the medication, or reduction of at least half their

symptoms. For patients who did not improve, later phases of the trial

will use other medications or combinations of medications to see what

might help those who did not benefit from the drug used in the first

phase of the trial.

" These antidepressants in routine clinical care produce outcomes

comparable with what is seen in research settings, " Trivedi said.

" These treatments do work in routine clinical care. There also has to

be careful monitoring of side effects. In addition, you have to

monitor dose and duration of the treatment, based on the patient's

progression. "

One expert thinks this study will eventually provide guideposts for

treating depression that physicians can follow.

" This study, when it is all finally published, will give us a very

good idea of how to treat treatment-resistant depression, and what the

next step is after the SSRI fails, " said Dr. L. Dunner, director

of the University of Washington's Center for Anxiety and Depression.

In the second study, researchers found the risk of suicide attempts

and of successful suicides actually dropped in the weeks following the

start of SSRI therapy.

" The risk of a serious suicide attempt in people who start taking

antidepressant medication is, fortunately, quite low -- less than one

in 1,000, " said lead author Dr. Greg Simon, a researcher at the Group

Health ative, in Seattle. " The risk actually goes down after

people start antidepressant medication. "

The study also found no increase in suicide risk with the newer

antidepressants, such as SSRIs, Simon added. " If anything, our data

suggests that with the newer antidepressants there is less risk than

with the older antidepressants, " he said.

For the study, Simons's team collected data on 65,103 patients who had

prescriptions for antidepressants between 1992 and 2003.

The researchers found the number of suicide attempts dropped by 60

percent in adults in the first month after starting treatment. The

suicide rate continued to drop in the succeeding five months.

Among all the patients, there were 31 suicides in the six months after

starting antidepressant therapy. That rate did not change from one

month after starting treatment or in subsequent months.

However, teens had more suicide attempts than adults. Simon's group

found that in the first six months of antidepressant treatment, the

suicide rate was 314 attempts per 100,000 in teens, vs. 78 attempts

per 100,000 in adults. For teens and adults, the rate was highest in

the month before treatment and dropped by about 60 percent after

treatment began, the researchers found.

In its 2004 warning, the FDA said people taking antidepressants should

be closely monitored because of the risk of suicide.

" People should be closely monitored, but not because these drugs are

especially risky, " Simon said. " The real problem in the treatment of

depression is that people start medicine and the medicine has side

effects or the medicine doesn't work right away, and they get

discouraged and they drop out. "

Dunner agreed that close monitoring is essential when prescribing

patients antidepressants. " Monitoring depression is very important, "

he said. " Often people come in for treatment when they are starting to

get worse. "

Monitoring is needed more for side effects from the drugs than to

watch for suicidal behavior, Dunner said. " Suicide is a pretty rare

event, " he said. " It is more important to monitor for side effects and

adherence to the medication. "

More information

The American Academy of Family Physicians can tell you more about

antidepressants.

[Guest guest]

Happy New Year everyone

With the New Year comes more new spin from the drug pushers.

http://www.forbes.com/lifestyle/health/feeds/hscout/2006/01/01/hscout529949.html

Health

Antidepressants Work and Don't Boost Suicide Risk: Studies

SUNDAY, Jan. 1 (HealthDay News) -- Contrary to what has been feared,

the antidepressants known as serotonin reuptake inhibitors (SSRIs) are

initially effective in as many as one-third of depressed patients and

don't appear to increase the risk of suicide, two new studies claim.

The reports, both of which were funded by the National Institute of

Mental Health, appear in the January issue of the American Journal of

Psychiatry.

The suicide findings seem to challenge a 2004 advisory by the U.S.

Food and Drug Administration that warned that suicidal behavior may

increase after treatment with SSRIs. However, the study did find that

suicide attempts were higher among teens than adults, a finding borne

out by other research.

The first report is based on early data from the Sequenced Treatment

Alternatives to Relieve Depression (STAR*D) trial, the largest study

of its kind. This research looked at the benefits of antidepressants

in " real world " settings.

" About a third of the patients achieved remission, " said lead

researcher Dr. Madhukar Trivedi, director of the Mood Disorders

Research Program and Clinic at the University of Texas Southwestern

Medical Center, in Dallas. " An additional 10 to 15 percent achieved a

response. "

The object of the study was to provide physicians with guidelines for

treating depression, Trivedi said. " The goal is to have patients

provided with an adequate dose of medication for an adequate time, " he

explained. " Treatment would be tailored for each individual patient to

get the most benefit from treatment. "

For the study, researchers looked at the results of prescribing the

SSRI Celexa to 2,876 patients with major depression. These patients

also had other physical and psychological problems. The researchers

found that about a third of the patients had their depression cured

during the first 12 weeks of treatment.

In addition, another 10 percent to 15 percent of the patients showed a

response to the medication, or reduction of at least half their

symptoms. For patients who did not improve, later phases of the trial

will use other medications or combinations of medications to see what

might help those who did not benefit from the drug used in the first

phase of the trial.

" These antidepressants in routine clinical care produce outcomes

comparable with what is seen in research settings, " Trivedi said.

" These treatments do work in routine clinical care. There also has to

be careful monitoring of side effects. In addition, you have to

monitor dose and duration of the treatment, based on the patient's

progression. "

One expert thinks this study will eventually provide guideposts for

treating depression that physicians can follow.

" This study, when it is all finally published, will give us a very

good idea of how to treat treatment-resistant depression, and what the

next step is after the SSRI fails, " said Dr. L. Dunner, director

of the University of Washington's Center for Anxiety and Depression.

In the second study, researchers found the risk of suicide attempts

and of successful suicides actually dropped in the weeks following the

start of SSRI therapy.

" The risk of a serious suicide attempt in people who start taking

antidepressant medication is, fortunately, quite low -- less than one

in 1,000, " said lead author Dr. Greg Simon, a researcher at the Group

Health ative, in Seattle. " The risk actually goes down after

people start antidepressant medication. "

The study also found no increase in suicide risk with the newer

antidepressants, such as SSRIs, Simon added. " If anything, our data

suggests that with the newer antidepressants there is less risk than

with the older antidepressants, " he said.

For the study, Simons's team collected data on 65,103 patients who had

prescriptions for antidepressants between 1992 and 2003.

The researchers found the number of suicide attempts dropped by 60

percent in adults in the first month after starting treatment. The

suicide rate continued to drop in the succeeding five months.

Among all the patients, there were 31 suicides in the six months after

starting antidepressant therapy. That rate did not change from one

month after starting treatment or in subsequent months.

However, teens had more suicide attempts than adults. Simon's group

found that in the first six months of antidepressant treatment, the

suicide rate was 314 attempts per 100,000 in teens, vs. 78 attempts

per 100,000 in adults. For teens and adults, the rate was highest in

the month before treatment and dropped by about 60 percent after

treatment began, the researchers found.

In its 2004 warning, the FDA said people taking antidepressants should

be closely monitored because of the risk of suicide.

" People should be closely monitored, but not because these drugs are

especially risky, " Simon said. " The real problem in the treatment of

depression is that people start medicine and the medicine has side

effects or the medicine doesn't work right away, and they get

discouraged and they drop out. "

Dunner agreed that close monitoring is essential when prescribing

patients antidepressants. " Monitoring depression is very important, "

he said. " Often people come in for treatment when they are starting to

get worse. "

Monitoring is needed more for side effects from the drugs than to

watch for suicidal behavior, Dunner said. " Suicide is a pretty rare

event, " he said. " It is more important to monitor for side effects and

adherence to the medication. "

More information

The American Academy of Family Physicians can tell you more about

antidepressants.