Consumers Reports Insights

Consumer Reports: Antidepressants can be helpful but risky

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Tuesday, December 1, 2009

Feelings of unhappiness, decreased energy, insomnia and irritability are all symptoms of depression. And antidepressants can help relieve depression.

But for some people, these drugs may also have dangerous or troubling side effects -- drowsiness, feelings of panic, nervousness, sexual problems, thoughts of suicide or weight gain -- and should be taken only by people who really need them. So it's alarming that a new study shows antidepressant use has nearly doubled in the United States since the mid-1990s.

In the study, published in the August issue of Archives of General Psychiatry, researchers analyzed data from a national survey of antidepressant use conducted in 1996 and again in 2005. The survey included people age 6 and older.

Between 1996 and 2005, the rate of those reporting that they had used antidepressants in the past year jumped from 5.8 percent to 10.1 percent. This translates to an increase from about 13.3 million people to 27 million. The change was more dramatic among whites than African Americans or Hispanics.

In its recent Best Buy Drug report on antidepressants, Consumer Reports notes that 60 to 70 percent of people with depression don't receive the treatment they need. So on the surface, an increasing number of people prescribed antidepressants is not necessarily a bad thing. But various factors revealed in the study give rise to other concerns.

One is that this analysis -- as well as other recent studies -- shows that people treated with antidepressants are increasingly less likely to see a psychotherapist or psychiatrist. This is worrisome because some studies show that antidepressants work best when used in concert with psychotherapy. And psychotherapy can be effective on its own in some cases, without the risk of antidepressants' side effects.

One possible reason for the drop-off in psychotherapy, the researchers note, is that it can be expensive. So if psychotherapy is something you want to pursue, check with your insurance provider to find out if it is covered and what your out-of-pocket payment will be.

Pharmaceutical companies nearly quadrupled their spending on consumer advertising for antidepressants during the period of the study. In 1999, drugmakers spent $32 million on direct-to-consumer advertising; by 2005, this figure had jumped to $122 million. Drug ads lead to increased prescriptions and often overstate the benefits of a drug while downplaying the risks.

If you decide to use medication to treat depression, you should know that Consumer Reports notes in its Best Buy Drug report that no one antidepressant has been shown to be more effective than the others. But some are more likely to cause certain side effects.

Your doctor or mental health professional can help you choose the right antidepressant. It is common that people try two or even three before finding one that works. Individual needs vary, and people respond to antidepressants quite differently.

Consumer Reports recommends these five as its Best Buy to consider for initial treatment:

-- Generic bupropion

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