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Can Long-term Treatment With Antidepressant Drugs Worsen The Course Of Depression?
March 17, 2003The Journal of Clinical Psychiatry releases a review by Giovanni A. Fava (University of Bologna) which is likely to stir a lot controversy and be disliked by the Big Pharma.
The possibility that antidepressant drugs, while effectively treating depression, may worsen its course has received inadequate attention.
A review of the literature, suggesting potential depressogenic effects of long-term treatment with antidepressant drugs was performed. A Medline search was conducted using the key-words tolerance, sensitization, antidepressive agents, and switching. This was supplemented by a manual search of Index Medicus under the heading "antidepressant agents" and a manual search of the literature for articles pointing to paradoxical effects of antidepressants.
A number of reported clinical findings point to the following possibilities: very unfavorable long-term outcome of major depression treated by pharmacological means; paradoxical (depression-inducing) effects of antidepressant drugs in some patients with mood and anxiety disturbances; antidepressant-induced switching and cycle acceleration in bipolar disorder; occurrence of tolerance to the effects of antidepressants during long-term treatment; onset of resistance upon re-challenge with the same antidepressant drug in a few patients; and withdrawal syndromes following discontinuation of mood-elevating drugs. These phenomena in susceptible individuals may be explained on the basis of the oppositional model of tolerance. Continued drug treatment may recruit processes that oppose the initial acute effects of a drug and may result in loss of clinical effect. When drug treatment ends, these processes may operate unopposed, at least for some time, and increase vulnerability to relapse. This hypothesis needs to be tested, even though its scientific exploration is likely to encounter considerable methodological and ideological difficulties. The clinical implications of this hypothesis in depression are considerable. Antidepressant drugs are crucial in the treatment of major depressive episodes. However, appraisal of paradoxical effects that may occur in susceptible patients during long-term treatment may lead to a more effective use of the drugs.
Psychotherapy and Psychosomatics, Journal of
A number of reported clinical findings point to the following possibilities: very unfavorable long-term outcome of major depression treated by pharmacological means; paradoxical (depression-inducing) effects of antidepressant drugs in some patients with mood and anxiety disturbances; antidepressant-induced switching and cycle acceleration in bipolar disorder; occurrence of tolerance to the effects of antidepressants during long-term treatment; onset of resistance upon re-challenge with the same antidepressant drug in a few patients; and withdrawal syndromes following discontinuation of mood-elevating drugs. These phenomena in susceptible individuals may be explained on the basis of the oppositional model of tolerance. Continued drug treatment may recruit processes that oppose the initial acute effects of a drug and may result in loss of clinical effect. When drug treatment ends, these processes may operate unopposed, at least for some time, and increase vulnerability to relapse. This hypothesis needs to be tested, even though its scientific exploration is likely to encounter considerable methodological and ideological difficulties. The clinical implications of this hypothesis in depression are considerable. Antidepressant drugs are crucial in the treatment of major depressive episodes. However, appraisal of paradoxical effects that may occur in susceptible patients during long-term treatment may lead to a more effective use of the drugs.
Psychotherapy and Psychosomatics, Journal of
Depression Current Events and Depression News RSSBurnout and mental distress strongly related to errors by US surgeons
Major medical errors self-reported by American surgeons are strongly related to both burnout and depression. Those findings appear today in the online edition of Annals of Surgery. The Mayo Clinic-led study included collaborators from Johns Hopkins and the American College of Surgeons.
Mother's Depression a Risk Factor in Childhood Asthma Symptoms, Study Suggests
Asthma symptoms can worsen in children with depressed mothers, according to research from Johns Hopkins Children's Center published online in the Journal of Pediatric Psychology.
Dispensing prescription drugs in 3-month supplies reduces drug costs by a third
Purchasing prescription drugs in a three-month supply rather than a one-month supply has long been regarded as a way to reduce the cost of drugs for patients and third-party payers. New research from the University of Chicago quantifies the savings for the first time.
New Down syndrome treatment suggested by Stanford/Packard study in mice
At birth, children with Down syndrome aren't developmentally delayed. But as they age, these kids fall behind. Memory deficits inherent in Down syndrome hinder learning, making it hard for the brain to collect experiences needed for normal cognitive development.
At-risk college students reduce HBP, anxiety, depression through Transcendental Meditation
The Transcendental Meditation technique may be an effective method to reduce blood pressure, anxiety, depression, and anger among at-risk college students, according to a new study to be published in the American Journal of Hypertension, December 2009.
Teens' mental health affects how long they stay in school, new study shows
Queen's University researcher Steven Lehrer has won a prestigious international award in recognition of his contributions to health economics.
Ethnic pride may boost African-American teens' mental health
Most adolescents who belong to an ethnic minority group wrestle not only with their self-esteem (like most teens), but also with identity issues unique to their ethnic group, such as dealing with social stigma. A new study tells us that young people's ethnic pride may affect their mental health.
Faulty body clock may make kids bipolar
Malfunctioning circadian clock genes may be responsible for bipolar disorder in children. Researchers writing in the open access journal BMC Psychiatry found four versions of the regulatory gene RORB that were associated with pediatric bipolar disorder.
Women with asthma feel worse
Women with asthma are more anxious, find it harder to sleep and are more tired during the day than their male counterparts, but nevertheless tend to be better at following their treatment.
Connection between depression and osteoporosis detailed by Hebrew University researchers
Research carried out among thousands of people has shown a clear connection between depression and a loss of bone mass, leading to osteoporosis and fractures.
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