Study: All Antidepressants Work the Same
Results from a new study suggest that all antidepressant medications — including Prozac, Paxil and Zoloft — work the same. So it really doesn’t matter which one you take. What this means is that doctors can very well base their prescription choices on each patient’s personal requirements, such as cost, side effects and personal preference.
Dr. David Schlager, a clinical assistant professor of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine, says, "They're all equally effective. They're interchangeable except for side effects, so psychiatrists do tend to 'exploit the side-effect profile' to find suitable medications for individual patients.”
According to information for the study, which appears in the Dec. 6 issue of Annals of Internal Medicine, as many as 27 million people in United States have taken antidepressants since 2005, including SSRIs like Prozac, Paxil and Effexor. The study was led by Dr. Gerald Gartlehner, and the analysis was mostly paid for by the U.S. Agency for Healthcare Research and Quality.
For the study, authors looked at information from 234 previously-published studies as well as data from random trials that each included information on at least 1,000 participants each. What the researchers found was that while there was no difference in the efficacy of the drugs, there were differences in how the drugs took effect, how they affected a patient’s quality of life and how severe the side effects were.
For example, the study found that Remeron worked faster than Prozac and Paxil. The study also found that Buporpion has less sexual side effects than Paxil, Zoloft and Lexapro.
"If a patient has insomnia, you would pick something more immediately sedating," Schlager said. "If the patient has decreased appetite and weight loss, you would pick something more likely to cause weight gain like mirtazapine."
Dr. Radu Saveanu, a professor of psychiatry at the University of Miami Miller School of Medicine, commented about how the cost of a drug may influence which drug would be chosen. He also pointed out that dosages should be brought into consideration when opting for one drug over another "because studies have shown that if patients have to take the drug less frequently, compliance is higher, which will make a big difference in terms of efficacy."
What this study shows is that since all of the drugs have proven to be equally effective, the drugs patients are prescribed are basically just a guessing process based on what patients can take both physically and financially. Future studies are hoping to be able to help doctors figure out which drugs to prescribe first to avoid the dangerous side effects linked to some of the medications.
"The real heart of the matter is, if they don't respond to one type of antidepressant, is there any guidelines about what you should try next?" Schlager asked.
