Continuing the discussion from the last post, a new study has shown that anti-depressant medication (ADM) has no more benefit than a sugar pill (placebo) when depression is less than very severe (1). This evidence, though not necessarily a reason to halt prescription of ADM for patients in that category, should certainly make clinicians reconsider the risks and benefits and discuss the results of this research with their patients.
If medication is not used, there are a number of other options available to treat depression including:
- Mental health counseling or psychotherapy, which studies have shown to be about as effective as medication.
- Exercise such as walking, swimming, yoga, tai chi or even gardening.
- Getting a good night’s sleep (set a regular time to go to bed, avoid daytime naps, avoid alcohol, caffeine and television before sleep, keep the bedroom dark, quiet and cool).
- Learn Mindfulness Meditation
- Avoid alcohol and illegal drugs and let your doctor know if you are using these.
- Try to enhance your social support by becoming involved in activities with other people.
For many people whose depression is milder or of short duration or clearly connected to life events, these measures will be preferable to medication. For patients already taking ADM who had less than very severe depression when it was prescribed, the new research raises the question of whether you should stop. More in the next post.
1. Fournier JC et al. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA. 303(1):47-53, 2010 Jan 6.
Tags: depression
