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Do anti-depressants help only the severely depressed?

A few weeks ago I read of a new study about antidepressants. USA Today characterized it like this: "A small study provides more evidence that, on average, antidepressants may be little more effective than a sugar pill in most pateints who take them." Hmm...

Meds for depression are a multi-billion dollar business in America. Doesn't everyone know someone who is on meds for depression or has taken them? So this news, to me, was rather surprising. I thought the miracle of intervention for depression with meds was pretty well documented.

Within days of the study's release, there were two New York Times opeds taking issue with it. One by Richard Friedman, MD, a psychiatrist at Weill Cornell Medical College, slammed the study for making a broad sweeping conclusion based on limited data. Friedman concluded, "Every once in awhile, a landmark study comes along and overturns everyone's cherished ideas about a particular treatment. But the current study is not one of them. So it would be a shame if it discouraged depressed patients from taking antidepressants."

It's safe to say that mental health experts all agree that the real tragedy in America is not that depression is overtreated but rather that depression is undertreated. The study raises the questions: Are we overmedicated and do physicians prescribe meds too quickly when alternative treatments should also be considered?

I contacted the lead author of the paper, Robert DeRubeis, PhD, a psychologist at Penn to talk about some of these issues. In a new 1:2:1: podcast you'll hear DeRubeis talk about the paper, the press it received and the criticism leveled by Friedman.

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