Mixing right drugs can treat Depression

The United States researchers on Tuesday reported that two-third of people with major depression can be treated effectively if they are patient enough to join hands with doctor and mix match therapies until they find which one works for them.

The researchers found out thirteen percent of the patients out of 123 who tried different medicines thrice didn’t succeeded but were helped when they tried fourth medicine.

Dr. A. John Rush, vice chairman of clinical sciences and a professor of psychiatry at the University of Texas Southwestern Medical Center at Dallas, said "The good news is that two-thirds of people can be relieved of their depression if they hang in there for up to four treatment steps. That's pretty significant for a tough illness."

The bad news is that it’s a bit more depressing for people who generally get tied up after so many trials and the possibility is that they relapse or return to the depressive state.

The findings were published in this month’s issue of the American Journal of Psychiatry

Depression is a common mental disease. It affects 21 million people around the world and is one of the top mental diseases in United States; nearly 15 million people suffer from it annually. Thus, the government launched the six year, $35 million study Sequenced Treatment Alternatives to Relieve Depression or STAR*D to test multiple medication to be used for the treatment of depression in real world settings – like in psychiatric clinics and doctors office.

Rush and colleagues study named as STAR*D had around 3,700 major depressive patients getting treatment across the United States in real world settings.

Initially the patients were made to start by taking Celexa, manufactured by Forest Laboratories and a drug in the class of selective serotonin reuptake inhibitors (SSIR’s).
It was found that nearly 37% of the patients went into remission.

Than the patients who were not affected were either continued with same drug or combined it with another SSIR’S named Wyeth's Effexor, a drug in a similar class called selective serotonin/norepinephrine re-uptake inhibitors or SNRIs. They were also made to add cognitive, 'talk therapy' either alone or in combination with the drugs. This helped at least 31% of the patients.

Those patients who were not helped in the first two steps were than passed on to third and fourth step where combination of drugs were used along with the cognitive therapy and was found that the success rate was around 13 to 14% .

Drugs used in the treatments were Effexor (a drug in class of SNRI), Remeron ( thyroid hormone) and nortryptyline (an antidepressant, in older class of tricyclics). All were either used alone or in combinations along with cognitive therapy.

Overall completion of the study found that 67% of the patients achieved full reemission of depressive symptoms by the end of one of the four treatments.

Dr. Thomas Insel, director of the National Institute of Mental Health, said "I think the overall results are hopeful."

"The problem with depression is that people and their families feel hopeless. The message here is that medication can be helpful," he added.

Rush said "The take-home message for patients is to hang in there and stay in treatment, even if several steps and various medications must be tried."

Depression is a common illness and it can be occur due to the hormonal imbalance in the brain or due to the changes that takes place in your life like loss of loved ones, unemployment, marital conflict, failure in love etc. Symptoms include feeling tired all day, worthlessness, don’t feel hungry, sadness, no interest in life, insomnia, thoughts of suicide, poor judgment and seeking solitude.

One should seek help from psychiatrist or psychotherapist. Depending on the diagnosis the psychotherapist can recommend treatments like Electroconvulsive therapy (ECT), it's helpful in severe case and when a patient can’t take medication, other psychotherapies like 'talking therapy' and behavioral therapy along with medication (antidepressant) or as such helps. Family and friends can also play a major role as they can help the person by encouraging him or her to seek treatment.