All Antidepressants Are Equally Effective
Side Effects, Not Depression Relief, Drive Patients', Doctors' Choice
Sept. 19, 2005 - Does it matter which antidepressant you take?
No, if fighting depression is all you care about. Yes, if you worry about particular side effects, how often you have to take pills, or if cost is an issue.
The findings come from a pooled analysis of studies comparing one new-generation antidepressant to another by Richard A. Hansen, PhD, and colleagues at the University of North Carolina, Chapel Hill.
"Not all antidepressant drugs work for every person. We found about 40% of patients do not respond," Hansen tells WebMD. "But with regard to comparing the number of people who respond to one versus the number who respond to another, there really aren't significant differences. For the most part, what we know is that they have a relatively equal likelihood of responding to each agent on a first try."
That leaves three things that are different about the drugs: their side effects, how often one must take them, and how much they cost.
"The big message is the side effect profile, and understanding how individual patients prefer different side effects," Hansen says. "We were able to identify the side effects that are more common for some drugs than others. So being able to match a patient and their preferences for anticipated side effects could improve prescribing and eventual drug-therapy outcomes."
Hansen and colleagues report their findings in the Sept. 20 issue of Annals of Internal Medicine.
Emory University psychiatry professor Philip T Ninan, MD, takes issue with the methods used in the Hansen study. He says that just because antidepressant drugs don't show any differences when all patients are considered as a whole doesn't mean there aren't differences in how the drugs work in specific subgroups of patients.
Ninan says neither depressed people nor their doctors care about a drug's efficacy -- defined by Hansen and most clinical trials as a 50% decrease in depressive symptoms. What matters to patients, Ninan says, is a drug's effectiveness -- its ability to put a person's depression into remission.
"Would you find a difference among these drugs if you looked at remission? That is an important question," Ninan tells WebMD. "Many of these studies don't report remission rates, so the data are not available."
All Antidepressants Are Equally Effective
Side Effects, Not Depression Relief, Drive Patients', Doctors' Choice
Sept. 19, 2005 - Does it matter which antidepressant you take?
No, if fighting depression is all you care about. Yes, if you worry about particular side effects, how often you have to take pills, or if cost is an issue.
The findings come from a pooled analysis of studies comparing one new-generation antidepressant to another by Richard A. Hansen, PhD, and colleagues at the University of North Carolina, Chapel Hill.
"Not all antidepressant drugs work for every person. We found about 40% of patients do not respond," Hansen tells WebMD. "But with regard to comparing the number of people who respond to one versus the number who respond to another, there really aren't significant differences. For the most part, what we know is that they have a relatively equal likelihood of responding to each agent on a first try."
That leaves three things that are different about the drugs: their side effects, how often one must take them, and how much they cost.
"The big message is the side effect profile, and understanding how individual patients prefer different side effects," Hansen says. "We were able to identify the side effects that are more common for some drugs than others. So being able to match a patient and their preferences for anticipated side effects could improve prescribing and eventual drug-therapy outcomes."
Hansen and colleagues report their findings in the Sept. 20 issue of Annals of Internal Medicine.
Symptom Improvement vs. Remission
Emory University psychiatry professor Philip T Ninan, MD, takes issue with the methods used in the Hansen study. He says that just because antidepressant drugs don't show any differences when all patients are considered as a whole doesn't mean there aren't differences in how the drugs work in specific subgroups of patients.
Ninan says neither depressed people nor their doctors care about a drug's efficacy -- defined by Hansen and most clinical trials as a 50% decrease in depressive symptoms. What matters to patients, Ninan says, is a drug's effectiveness -- its ability to put a person's depression into remission.
"Would you find a difference among these drugs if you looked at remission? That is an important question," Ninan tells WebMD. "Many of these studies don't report remission rates, so the data are not available."