Comparing Medical Treatments for Depression

About one in every six adults experiences depression at some point in his or her life. The good news is that depression can be treated to give you a better quality of life. But finding the right treatment that fits your needs can sometimes be tricky.

The most common treatments are antidepressant drugs, counseling or a combination of the two. If you or a loved one is prescribed a drug to treat depression, you’ll want to understand its benefits and side effects because certain treatments work better for some than others. For example, four of every 10 people will find that the first antidepressant they take may not ease their symptoms, and they’ll need to try a different drug to get the best results.

Finding the right antidepressant for you can be confusing and frustrating. To help you work with your doctor or nurse to select the right medicine, my agency, the Agency for Healthcare Research and Quality (AHRQ), developed a guide on antidepressants for adults with depression. In addition to discussing the different drugs used to treat depression, the guide also gives practical information on depression.

Scientists used a type of research called comparative effectiveness to develop the guide, which summarizes the findings of nearly 300 published studies. Comparative effectiveness research focuses on a specific health problem and asks what the pluses and minuses are of the current treatments.

This research does not dictate your choice. That decision is always left to you and your doctor. But it does provide information that can help you and your doctor make the best choice.

For many years, AHRQ has sponsored this type of research through its Effective Health Care Program. The federal government is boosting funding for this kind of research so doctors, nurses and patients have solid scientific information on which to base their treatment decisions. In fact, this guide is just one of several consumer guides available from AHRQ.

When it comes to treating depression, any drug’s success depends on hitting the right balance between relieving symptoms and minimizing side effects.

This guide concludes that most people can find an antidepressant that works for them. Six out of 10 people feel better with the first drug they try. However, most people need to take an antidepressant for six weeks before they get the full benefit.

The guide also summarizes important information about possible side effects—including weight gain, constipation, diarrhea, and sexual problems—and which drugs are more or less likely to cause these side effects. For example:

• About one in every six adults experiences depression at some point in his or her life. The good news is that depression can be treated to give you a better quality of life. But finding the right treatment that fits your needs can sometimes be tricky.  People who take mirtazapine (sold as Remeron) gain more weight than people who take citalopram (Celexa), fluoxetine (Prozac) or other antidepressants. 
• People who take venlafaxine (Effexor) experience nausea and vomiting more often than people who take other antidepressants.

Medicines can improve the quality of your life if you suffer from depression. Armed with good research, you and your doctor can make the best choice for you.

More Information

Agency for Healthcare Research and Quality podcast on antidepressants

Carolyn M. Clancy, a general internist and researcher, is the director of the U.S. Agency for Healthcare Research and Quality.