Decision Assist

Depression medications

Introduction

The purpose of this tool is to help you decide whether depression medication is right for you. When making a decision like this, you must balance:

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. Medication always has potential side effects, and you should be fully informed about the risks and benefits of this type of medication. There is usually no exact “right” or “wrong” answer.

Your physician may make certain recommendations to you. However, the final decision about whether to use this medication rests with you.

What is the medication?

Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. But true clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life.

Depression is a treatable illness, with many therapeutic options available. Increasingly, professionals are viewing major depression as a chronic illness, meaning the condition often returns when treatment is stopped. Therefore, medical intervention and help must be ongoing.

Another type of chronic depression called dysthymia is usually milder.

Forms of depression

Patients with chronic depression have several options, including psychotherapy, medications called antidepressants, or both. In general, the treatment choice depends on the degree and type of depression and other accompanying conditions. It also may depend on age, pregnancy status, or other individual factors.

Several studies have supported a combination of cognitive behavioral therapy (CBT) plus antidepressant medications. These drugs can include:

Many of these newer antidepressants are effective and have very moderate side effects. Some may be beneficial in treating anxiety. They may also help treat disorders that have not responded to previous drug treatment, including premenstrual dysphoric disorder, seasonal affective disorder, atypical depression, and recurrent, brief bouts of depression.

Key points

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Review Date: 9/19/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Previously reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. (6/6/2008).

References:
  • Gijsman HJ. Geddes JR, Rendell JM, Nolen WA, Goodwin GM. Antidepressants for bipolar depression: a systematic review of randomized, controlled trials. American Journal of Psychiatry. September 2004;161(9):1537-47.
  • Gunnell D, Ashby D. Antidepressants and suicide: what is the balance of benefit and harm. BMJ. July 3, 2004;329(7456):34-8.
  • Hughes J, Stead L, Lancaster T. Antidepressants for smoking cessation. Cochrane Database of Systematic Reviews. 2004;(4):CD000031.
  • Institute for Clinical Systems Improvement. Health Care Guideline: Major Depression in Adults in Primary Care. 13th ed. May 2010. Accessed September 18, 2010.
  • Mann JJ. The medical management of depression. New England Journal of Medicine. October 27, 2005;353(17):1819-34.
  • Rohan KJ, Roecklein KA, Tierney Lindsey K, et al. A randomized controlled trial of cognitive-behavioral therapy, light therapy, and their combination for seasonal affective disorder. J Consult Clin Psychol. Jun 2007;75(3):489-500.
  • Zuckerbrot RA, Cheung AH, Jensen PS, Stein RE, Laraque D; GLAD-PC Steering Group. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, assessment, and initial management. Pediatrics. Nov 2007;120(5):e1299-312.
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