11 posts tagged “MDD”

Key takeaways from a recent study on antidepressants

Posted 1 month ago by

The World Health Organization reports 300 million people live with depression, but less than half receive effective treatment.

A recent study in the journal The Lancet has been making headlines for comparing the effectiveness of antidepressant medications — information that is often lacking for patients trying to make informed choices about their treatments. They found that all of the medications were modestly more effective than a placebo and some were more effective than others. With help from our research team, we took a closer look at what these findings really mean and how they compare to what members are reporting on PatientsLikeMe.

Let’s break down the research

Researchers looked at 474 placebo-controlled and head-to-head trials including a total of 100,000+ paients on their first line of treatment for major depressive disorder. They compared the effectiveness of 21 different antidepressants to each other and a placebo. The medications were randomly assigned.

Key takeaways

  • Some antidepressants, such as escitalopram (Lexapro), mirtazapine (Remeron), paroxetine (Paxil), agomelatine (Melitor), and sertraline (Zoloft) were more effective with lower dropout rates (patients who stopped taking the medication due to side effects or other factors).
  • Medications like Reboxetine (Edronax), trazodone (Desyrel), and fluvoxamine (Fevarin) had lower efficacy.
  • The antidepressants with the highest efficacy were amitriptyline (Elavil) and escitalopram (Lexapro), while fluoxetine (Prozac) had the lowest.
  • All of the antidepressants were more effective than a placebo in treating MDD, although the effects were modest.

Some limitations

  • The majority of the clinical trials included in this study were selective and didn’t include people with more complex situations (like living with another condition in addition to MDD).
  • The study didn’t include people with treatment-resistant depression (which could be as many as 30% of people with MDD who have tried two or more medications).
  • Researchers only analyzed short-term treatment (8 weeks), so it’s unclear how the antidepressants may work in the long-term.
  • The study only looked at treatment effectiveness, not tolerability (when the medication works but a person stops taking it because of the side effects).
  • The findings were general and based on average results (across all people in the trials), so there’s little insight on targeting treatments for individuals.

On PatientsLikeMe

Here are some commonly reported ways PatientsLikeMe members are treating their major depressive disorder (MDD):

Bupropion (Wellbutrin)

  • 2,000+ members report taking bupropion (Wellbutrin)
  • 63% say that it’s at least moderately effective in treating their MDD

Duloxetine (Cymbalta)

  • 1,800+ members report taking duloxetine (Cymbalta)
  • 67% say that it’s at least moderately effective in treating their MDD

Venlafaxine (Effexor XR)

  • 1,700+ members report taking venlafaxine (Effexor XR)
  • 74% say that it’s at least moderately effective in treating their MDD

Sertraline (Zoloft)

  • 1,500+ members report taking sertraline (Zoloft)
  • 55% say that it’s at least moderately effective in treating their MDD

Fluoxetine (Prozac)

  • 1,500+ members report taking fluoxetine (Prozac)
  • 61% say that it’s at least moderately effective in treating their MDD

Finding what works for you

Many patients have tried several antidepressants in their search to find what works for them (if you’re a PatientsLikeMe member, you can check out what others have shared about this in a recent study). Some studies also show that medication may be more effective when combined with cognitive behavioral therapy. Talk to your doctor to find the best approach to treatment for you.

Are you on an antidepressant? Join PatientsLikeMe today to share your experience and learn from the community.

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Getting out of bed: The “One hour rule” and other tips

Posted 5 months ago by

Does getting out of bed in the morning ever seem like an overwhelming task? You’re not alone. PatientsLikeMe members are talking about it a lot in the mental health forum. Read on to learn what’s worked for others on difficult mornings.

Give yourself no more than an hour

Elyse Raffery, contributor to The Mighty, shared her strategy for the “One Hour Rule” to get out of bed on the days she’d rather not move from beneath the covers:

“Within one hour of waking up, I have to be out of my bed. If I look at the clock when I wake up and it is 9 a.m., by 10 a.m., I cannot still be lying in bed. I am a competitive person, and even some gentle competition with my own brain helps me sometimes.”

Louder alarms, brighter lights and more tips from PatientsLikeMe members

Check out these practical morning tips from other members in the forum:

“I got a much louder alarm. I went back to the classic two bell analog alarm clock… so loud that my cat bolts from the room.”

“Now I have a routine where I get up, turn the light on, and listen to the radio for ten minutes. Then I get out of bed. The ‘light’ is a full-spectrum, really bright light. You might find that turning on bright lights when you get up helps. You can put them on timers, too, so that they light up when your alarm goes off.”

“Write down or think about something you are looking forward to on the next morning/day. Motivate yourself to want to get up by planning a special item for breakfast (cinnamon toast) or wearing a certain shirt you like or planning a half hour of your favorite music with headphones for the first ten minutes. Something that will keep your head on straight.”

Some shared wisdom from around the web:

  • Make small goals: “If you can’t do one thing a day, try one thing every two days, or even one thing every week. A slowly fought battle is still one you can win in the end.”
  • Ask for help: “We’re all human, there are times we can all benefit from support.”
  • If you have a pet: “Pets are also something great to turn to, as they rely on you to care for them, which gives you a sense of responsibility each day.”

Try to get enough sleep the night before

Chronic sleep problems — common in many mental health conditions — can often be part of the issue. According to the Harvard Health Newsletter,

  • Sleep problems affect more than 65% to 90% of adult patients with major depression
  • In bipolar depression, 23% to 78% of patients report that they have trouble getting out of bed
  • Sleep problems are also common in people with post-traumatic stress disorder (PTSD).

Here are some strategies for sleeping better (and potentially getting up more easily.) Talk to your doctor about what might work best for you:

  • Exercise can improve sleep, and can help regulate your mood to make mornings easier
  • Maintaining a regular sleep-and-wake schedule, or “sleep training” — staying awake longer so that your sleep is more restful
  • Keeping your bedroom cool and dark, and banishing electronics from the bedroom
  • Meditation and guided imagery, deep breathing, and progressive muscle relaxation ─ alternately tensing and relaxing muscles ─ can reduce anxiety that can ruin sleep and make mornings so hard

Have you tried the “One Hour Rule” or something else to help you get out of bed? Log in or join PatientsLikeMe and jump in the conversation.

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