Recent review suggests Agomelatine is as effective as other antidepressants, but controversy persists

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In spite of widely available different antidepressants, major depression does not respond adequately in up to one third of patients. Overall, the need for both reliable and well-tolerated treatment has remained unmet for a sizeable proportion of people with depression. In the past couple of years, there has been controversy about the suitability of Agomelatine (Valdoxan) [read the full story...]

Little differences among antidepressants regarding sexual dysfunction, but bupropion performs best

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Antidepressant treatment is associated with a variety of side effects, including emotional changes, weight gain or fatigue. As pharmaceutical treatment has evolved, clinicians have become increasingly aware of another major adverse effect of modern antidepressants: sexual dysfunction. Current figures estimate that up to every second patient will, at some stage, experience reduced sexual function, which [read the full story...]

Largest RCT so far suggests that ketamine may be useful in the acute treatment of refractory depression

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Major depression is a serious mental illness that often does not respond to mainstream drug treatment (antidepressants). In addition, there is usually a delay of 2-6 weeks before mood improves significantly. In situations like this, when at least two conventional antidepressants have been tried without success, depression is considered treatment-resistant. While multiple different strategies to [read the full story...]

Systematic review highlights a lack of evidence about using antidepressants to treat cancer patients with depression

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Having a life threatening disease such as cancer and undergoing gruelling treatment can have detrimental psychological effects. According to a recent review, for instance, the prevalence of depression among cancer patients is 10.8%, when assessed by a standardised clinical assessment (Ng et al. 2011). The authors of this meta-analysis make the argument that established criteria [read the full story...]

New Cochrane review finds weak evidence that drug combinations are more effective than monotherapy in psychotic depression

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Major depression remains a serious condition that often proves refractory to pharmacological or psychotherapeutic interventions. Because depression can have many “faces”, clinicians should be aware of the great symptom variability among depressed patients and consider subforms when prescribing medication.  In a sizeable amount of patients (up to 25%, Coryell et al., 1984), depression presents with [read the full story...]

Cost-effectiveness of St John’s wort for treatment of depression

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Herbal medicines often represent a cheaper alternative, or a low-cost complement, to standard pharmacotherapy. As a result, improved cost-effectiveness is often touted as a likely benefit of the use of complementary and alternative medicine (CAM). Many, myself included, have been openly critical of CAM research, while others have suggested ways in which CAM research could [read the full story...]

Common antidepressants associated with increased risk of postpartum haemorrhage

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Postpartum haemorrhages are serious birth complications that represent one of the leading causes of maternal mortality and morbidity. While incidences of postpartum haemorrhages have risen steadily in the past decades (in the US alone, numbers increased from 2.3% to 2.9% from 1994 to 2006), there is little evidence as to why. Antidepressants – especially selective [read the full story...]

CAM: Many of us are using it, despite poor evidence. Whats going on?

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Complementary and alternative medicine (CAM) therapies are often perceived to be as effective as conventional treatments, more “natural”, less expensive, have fewer side-effects and are easily available without a prescription. But do these perceptions match up with the reality? Can CAM therapies be helpful additions to conventional treatments? This alludes to an interesting sociological question [read the full story...]

Cochrane review says there’s insufficient evidence to tell whether fluoxetine is better or worse than other treatments for depression

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Depression is common in primary care and associated with a substantial personal, social and societal burden. There is considerable ongoing controversy regarding whether antidepressant pharmacotherapy works and, in particular, for whom. One widely-prescribed antidepressant is fluoxetine (Prozac), an antidepressant of the selective serotonin reuptake inhibitors (SSRI) class. Although a number of more recent antidepressants are [read the full story...]

Study suggests link between depression, antidepressants and antibiotic-related clostridium difficile infection

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Hospitals are supposed to make people better, not worse – so hospital-acquired infections are always a big topic. Clostridium difficile infection (CDI) is the most commonly diagnosed cause of antibiotic-associated diarrhoea, and causes more than 7,000 deaths each year in the US alone. There have been studies into risk factors for CDI, one of them [read the full story...]