Some Depression Treatments Are Going Unused
Fears surround use of shock therapy and even antidepressants
(HealthDayNews) -- Though viewed with suspicion and concern by many people, shock therapy and antidepressants remain the most effective treatments for moderate to severe depression, most experts contend.
An estimated 17 percent of people worldwide are affected by depression, which can be incapacitating and even fatal. However, fewer than half of people with depression seek medical help for the condition, according to researchers at the University of Edinburgh in Scotland.
Apprehension about treatments is one reason why so few seek help, they say.
For a study first published in The Lancet, the researchers analyzed the previous five years of research into depression. That research, they concluded, showed that electroconvulsive therapy (the medical term for shock therapy) and antidepressant medications provide significant benefit to people with depression.
Antidepressants were described as the "mainstay of antidepressant therapy," with their benefits outweighing any "publicly perceived risk."
Public distrust of antidepressants may have been exacerbated by a U.S. Food and Drug Administration warning in 2004 that a particular class of antidepressants, known as serotonin reuptake inhibitors, or SSRIs, could increase the risk of suicidal behavior, especially in children and teens.
Some recent studies have disputed that opinion.
The Scottish study "is a little bit corrective for what they call this 'moral panic' around the claim that antidepressants can facilitate suicidal ideation or behavior," Dr. Jon A. Shaw, director of child and adolescent psychiatry at the University of Miami School of Medicine, told HealthDay.
"It's a judicious attempt to try to stabilize the debate, and really address what the empirical evidence really demonstrates," Shaw added.
The Edinburgh study also concluded that electroconvulsive therapy (ECT) is "the most effective treatment for deep depression, especially if it presents with psychotic symptoms."
Although many consumers and even some medical professionals may regard the treatment -- which involves the use of electric shocks to cause seizures in the brain -- as a relic of a bygone era, it is still commonly used for certain types of depression.
"ECT is not considered for garden-variety depression," Dr. Catherine Birndorf, assistant professor of psychiatry and of psychiatry in obstetrics and gynecology at New York Presbyterian Hospital/Weill Cornell Medical Center in New York City, told HealthDay.
"If it's more refractory, if other treatments have failed or it's suicidal depression and you don't have time to wait around to see if a medication is going to work, it's considered the gold standard of treatment," she said.
Birndorf said that the public perception of shock therapy as a cruel form of treatment is not accurate.
"It's highly humane," she said. "The myth of what it is and what it looks like is still rampant, and doesn't appeal to our culture. The efficacy is well-demonstrated. If used appropriately, it is sometimes lifesaving."
In their study, the researchers also looked at other physical treatments for depression -- including neurosurgery, magnetic seizure therapy, vagal nerve stimulation and transcranial magnetic stimulation. Most of these, they said, are still considered experimental.
On the Web
To learn more about depression, visit the American Academy of Family Physicians.
SOURCES: HealthDay News; Jon A. Shaw, M.D., professor and director of child and adolescent psychiatry, University of Miami School of Medicine, Miami; Catherine Birndorf, M.D., assistant professor of psychiatry and of psychiatry in obstetrics and gynecology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City; Jan. 14, 2006, The Lancet
Author: Robert Preidt
Publication Date: Jan. 31, 2007
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