Antidepressants Used by 78 Percent of Respondents With Depression or Anxiety

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Depression

Antidepressants Used by 78 Percent of Respondents With Depression or Anxiety

By

Jun 1, 2010 - 10:36:59 AM

Patients in Talk Therapy Did Just As Well As Those Only Taking Medication;

Respondents Were Equally Satisfied With Psychologists, Social Workers or

Licensed Therapists



(HealthNewsDigest.com) - YONKERS, N.Y., -- Reflecting the tremendous growth in

the use of antidepressants, nearly 80 percent of people seeking treatment for

depression or anxiety were prescribed antidepressants according to a recent

survey of Consumer Reports (CR) subscribers. The report also finds that anxiety

is on the rise. Of the 1,500 subscribers seeking treatment, 58 percent had

experienced anxiety, up from 41 percent in 2004 when CR last surveyed

subscribers about these conditions. The report is available at

www.consumerreportsenespanol.org.

The 2009 survey provides a window into how mental health treatment is practiced

in the real world, plus ratings of drugs readers found effective. The survey

found that older, often less expensive antidepressants known as SSRIs (selective

serotonin reuptake inhibitors) like Lexapro, Celexa, Prozac and Zoloft work just

as well, and with fewer side effects, than newer, more costly drugs known as

SNRIs (serotonin and norepinephrine reuptake inhibitors) like Cymbalta and

Effexor. SSRIs and SNRIs address depression by altering the levels of certain

brain chemicals.

Some good news: sexual side effects appear less common than in the 2004 survey,

possibly because people are taking drugs like bupropion (Wellbutrin and generic)

which has fewer sexual side effects than SSRIs and SNRIs, or they're adding

another medication such as sildenafil (Viagra) as an antidote to sexual side

effects.

Readers Rate Antidepressants: Consumer Reports asked readers who took drugs for

anxiety, depression or both within the past three years to rate them. Responses

are based on 1,386 experiences.

SSRIs

(Lexapro,

Celexa,

Prozac, SNRIs

and (Cymbalta, Bupropion

Drug Class Zoloft) Effexor) (Wellbutrin)

Effectiveness

Helped A Lot 53% 49% 48%

Helped Somewhat 35% 36% 38%

Side

Effects

Weight Gain 16% 22% 12%

Loss of Sexual

Interest/Ability 31% 36% 23%

Sleep Problems 12% 16% 17%

Source: Consumer Reports National Research Center

When asked to rate antidepressants, 53 percent of respondents taking SSRIs said

they helped " a lot. " SNRIs fared no better, with only 49 percent of respondents

reporting they helped " a lot. " When it comes to side effects, SSRIs performed

better than SNRIs with 31 percent of respondents reporting sexual side effects,

16 percent reporting weight gain, and 12 percent reporting sleep problems. Of

those taking SNRIs, 36 percent reported sexual side effects, 22 percent reported

weight gain, and 16 percent reported sleep problems. Bupropion, which is neither

an SSRI nor an SNRI, helped 48 percent of respondents " a lot. " In terms of

sexual side effects and weight gain, it was tolerated better than the SSRIs and

SNRIs.

Drugmakers spent almost $300 million in 2009 on ads for two newer

antidepressants: duloxetine (Cymbalta: " When you're depressed, where do you want

to go? Nowhere. " ) and desvenlafaxine (Pristiq: " I feel like I have to wind

myself up just to get out of bed. " ). " Pharmaceutical companies stand to profit

most from convincing consumers that drugs are the only answer to depression and

anxiety, and that newer, more expensive drugs are a better alternative to older

drugs and their generic counterparts, " said Metcalf, senior program

editor, Consumer Reports Health. " Our survey shows that a combination of therapy

and medication works best, and that despite the intense marketing push consumers

are subjected to, there is no evidence that newer drugs like Pristiq and

Cymbalta work any better than older medications in their class. "

Talk therapy offers two advantages over medication: no drug side effects and

tools you can use for the long term. It received high marks from CR's survey

participants--91 percent said therapy made things " a lot " or " somewhat " better.

People who stuck with talk therapy for at least seven sessions had significantly

better outcomes that those who went to six or fewer sessions. What's more, they

scored as high as people treated mostly with medication on an overall outcome

scale.

However, the type of therapist was less important: those who saw Psychologists

(Ph.D.s), social workers (M.S.W.s), or licensed professional counselors

(L.P.C.s) all reported equal levels of satisfaction.

Tips for managing anxiety and/or depression:

-- Invest in talk therapy: Depending on the severity of your symptoms,

therapy may be a good first step. And, you can always talk to your

therapist about adding medication later.

-- One-size doesn't fit all when it comes to antidepressants: According

to survey respondents, the median number of drugs tried was three, so

it is important to expect some trial and error on the road to finding

the right treatment for you.

-- What to try first: According to Consumer Reports Best Buy Drugs,

generic bupropion, citalopram, fluoxetine, and sertraline are among

the best initial options to consider. Consult with your doctor about

beginning with the lowest dose possible and if you're not seeing

progress in 6 to 8 weeks, talk to your doctor about a higher dose or

different medication.

-- Expect some side effects: The survey shows that side effects are much

more common than what is reported in the package inserts consumers get

when they fill their prescriptions. For example, the rates of sexual

side effects reported for the SSRIs and SNRIs (see chart above), were

more than double those reported by the drug companies, which can

carefully choose participants who might be less inclined to experience

adverse effects.

The report also provides tips on how to pay for treatment for your depression

and/or anxiety:

-- Take advantage of a flexible spending account if you have one.

-- If you have to pay out of pocket and have a limited income, ask if

your therapist will give a discount off the regular fee.

-- Be on the lookout for a new law that is scheduled to into effect on

July 1, 2010. It will require group health plans that offer

mental-health coverage to treat it the same way they do other types of

medical care. That means they can't charge different co-pays and

deductibles for mental-health treatment, or cut you off after 20

therapy visits if they allow unlimited doctor visits for other

conditions.

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