Furious Seasons

July 02, 2007

An Interesting Study On Treating Depression

Turns out that getting treatment--meds, psychotherapy or both--works to eliminate suicide attempts soon after a patient begins treatment. Culled from 100,000 or so patient records by Seattle's own Group Health Cooperative, the resultant paper is not yet available on the APA's website. But in a press release, GHC's Greg Simon notes:

“Our study indicates that there’s nothing specific to antidepressant medications that would either make large populations of people with depression start trying to kill themselves—or protect them from suicidal thoughts,” said Dr. Simon. “Instead, we think that, on average, starting any type of treatment—-medication, psychotherapy, or both-—helps most people of any age have fewer symptoms of depression, including thinking about suicide and attempting it.” That said, he likened population-based studies—both observational studies such as this one and randomized controlled trials of medications—to “circumstantial evidence” about what happens to individual patients.

It's not clear whether meds-alone or therapy-alone was better than the other. Nor does the study really prove the release's PR claim that it's shedding new light on the SSRI black boxes. But the results fit my contention that treatment of any kind for depression can have positive effects--not so much because of the meds or therapy involved but because there is a kind of nurturing in medical care and patient self-care that in its initial phases is powerful.

It'd be interesting to see what results GHC--who is very handy with the numbers--would get from a study of suicide completers who were in their system and what treatment modalities they'd been using.

Posted by Philip Dawdy at July 2, 2007 09:24 AM

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Comments

From everything I've read, it's my understanding that there is no real difference in the outcomes between meds alone and therapy alone. Therapy is equally effective as meds (if not a slight bit better) without the dreaded side effects that meds have.

I think it has a lot to do with what the person's 'theory of change' is. If a person believes that meds are going to help, there is a much better chance that they will. If a person believes that therapy will work, then therapy has a better chance of working. If the person believes that standing on their head all day will help...well, I think you get my point.

I believe it's true that when people start any kind of treatment, they start having fewer symptoms of depression, etc. I believe I've read somewhere that positive change can begin as early as the point of deciding to go to treatment or making that first appointment.

I apologize for not being able to give references for the stuff I'm talking about, but I just plain ol' can't remember where I read it. I've got to start keeping better track of the stuff I read. I've had my brain fried by ECT and by being severely over-medicated in the past, so please forgive my lack of brain cells. :-P

Oh...A lot of the stuff I'm talking about is at talkingcure.com (just remembered.)

I love this site, btw. :)

Posted by: onlylife at July 2, 2007 10:26 PM

They also might not have accurate patient accountability with who remained on the prescribed anti depressants or who dumped them due to side effects. When my PCP prescribed 40mg of Prozac for "stress" I never had such horrific suicidal thoughts in my life, and never felt like it since coming off of that stuff. I titrated down slowly off of it, and never felt comfortable telling the PCP doc what I had gone through. It wasn't until a future check up where they review what meds a person is on, that I admitted to going off of it.He didn't question me as to why either. Of course he did prescribe the Prozac for "anxiety and stress" so depression wasn't a label to be recorded.Prescribing psych meds for other reasons such as anxiety vs. depression, etc. could throw this data out as well. Same for Trazedone, an anti depressant he prescribed for insomnia. Same for Zyprexa he prescribed for "anxiety". All of that anxiety he prescribed anti depressants and even Zyprexa for---was for un diagnosed bipolar disorder. That 2003 prescription for Zyprexa and anxiety sounds a lot like off-label use doesn't it?

Posted by: Stephany at July 3, 2007 05:53 AM

I need to add to my previous post for what it's worth for thought re: PCP doctors prescribing psych meds to patients. In 2003 when that doctor gave me Zyprexa as an add-on to the Prozac for "anxiety" I was given a bag full of Prozac boxes[samples].I asked why I would be taking an anti psychotic for stress and anxiety and he told me it worked for that. I also had severe edema in the ankles so bad that he looked it up for side effects and took me off of it. I seriously do not believe that general practioners should be handing out psych meds.

Posted by: Stephany at July 3, 2007 05:58 AM

"It'd be interesting to see what results GHC--who is very handy with the numbers--would get from a study of suicide completers who were in their system and what treatment modalities they'd been using."

I **like** that..

Posted by: Cindy Sue Causey at July 3, 2007 03:10 PM