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Antidepressants: Get the Facts (cont.)

What do other findings show about using antidepressants?

Numerous studies support the benefit of antidepressants in improving mood, increasing ability to function socially, and easing physical complaints of joint pain, insomnia, and low energy.

According to Ronald R. Fieve, MD, psychopharmacologist and professor of clinical psychiatry at Columbia Presbyterian Medical Center in New York City, its not unusual for an antidepressant to take two to six weeks to have an effect on a patient's mood.

"People must realize that we've come a long way in reducing the side effects of antidepressants since first prescribing the tricyclics," Fieve says. "And while drug companies have reduced medication side effects with the newer [antidepressants], there's still not much improvement with onset of action or efficacy."

Fieve notes that in his practice, a good number of patients dramatically come out of their depression within 10 days to two weeks. "About 65% see improvement on the first antidepressant, and 85% of patients succeed on one to three antidepressant trials."

Why wouldn't an antidepressant work?

According to Fieve, sometimes the doctor chooses the wrong antidepressant, or the right antidepressant in the wrong dosage, or does not administer the antidepressant for at least six weeks at the highest dose tolerable to achieve full therapeutic results.

In addition, if the depressed patient has problems with alcohol or drug abuse and takes an antidepressant, the medication isn't getting at the real problem. There are also patients who are heavily medicated on tranquilizers who wonder why an antidepressant doesn't work to ease their depression. Coming off the tranquilizers may improve mood, Fieve says.



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