If you or a loved one is suffering from a mental health issue, the focus is on getting better. But once you are feeling better, what's next? Dr Byrne discusses why RELAPSE PREVENTION should be an important part of your treatment plan.
When Prozac was first introduced in 1987, it generated a wave of excitement – finally, there seemed to be a new antidepressant medication with fewer side effects that worked well. Over the years, there has been a shift towards disappointments – efficacy of antidepressants seems low, side effects seem high, and placebo effects may be larger than we first thought.
To date, we do not have a good explanation for why antidepressants work for some people and not others. Perhaps our best data comes from a government study called STAR-D (Sequenced Treatment Alternatives to Relieve Depression)*. This study showed that about the first antidepressant medication eliminated depression in about one-third of patients and improved depression in about one-half of patients. In the next level, some patients had a medication switch, and depression was eliminated in another one-quarter of these patients. Other patients tried to add on another medication and about one-third of these patients became symptom-free. There were an addition third and fourth level switch available. Over the course of the total four levels, about 70% of patients became symptoms free.
So what does this mean? Even in a controlled study, there were 30% of patients who did not become symptom-free, even after 4 different medication changes! Clearly, medication does not work for everyone.
So what can you do? Here are some options you can consider:
Live mentally healthy,
Dr. Jennie Byrne
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