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.
- 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.
- 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.
Here are some commonly reported ways PatientsLikeMe members are treating their major depressive disorder (MDD):
- 2,000+ members report taking bupropion (Wellbutrin)
- 63% say that it’s at least moderately effective in treating their MDD
- 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
- 1,500+ members report taking sertraline (Zoloft)
- 55% say that it’s at least moderately effective in treating their MDD
- 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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Studies have shown that practicing yoga can have positive effects on people with depression. So we tapped Jamie – a PatientsLikeMe research assistant who is also a certified yoga instructor – to show us some poses with mental health in mind. She put together a 5-minute, beginner-level flow that you can try at home. (As always, check with your doctor before trying a new type of exercise.)
“I practice yoga to manage my mental and physical health, and to bring mindfulness to my day,” Jamie says. Don’t speak yogi? Here’s a breakdown of the poses (and phrases) featured in the video, plus some of their perks:
- Pranayama – The practice of purposefully controlling or regulating your breath. Benefits: Settles the mind and body in preparation to practice yoga.
- Dirga (pronounced “deerga”) – A form of pranayama, this three-part breath involves inhaling into your lower belly (with your right hand on your belly), then into your diaphragm or midsection of the lungs, and finally into the chest (with your left hand on your chest) – and reversing this flow when you exhale. Benefits: Helps increase oxygen to the heart and lung to counteract shallow breathing – which can occur with depression or anxiety, frequent sitting and poor posture.
- Cat/cow – A pair of simple poses done on your hands and knees. For “cow,” inhale as your belly drops and your gaze rises, and for “cat,” exhale as your spine rounds and your chin comes to your chest. Benefits: This flow brings awareness and energy to the entire length of the body while also creating flexibility in the spine.
- Downward dog, or “downdog” – Another simple pose, done on your hands and feet, that involves the entire body and lengthens the back from head to foot as you bend at the waist. Benefits: It’s gently energizing and balancing for the mind and body.
- Sun salutation A, or “sun A” – One of the easiest and most common sequences in yoga, which can be done at any pace to be more or less energizing. It involves reaching upward toward the sky, then folding forward to touch your shins or the floor, stepping back into a plank pose, lowering your body to the floor, then pressing up with your arms and chest into a “cobra” pose, and finally, returning to a tabletop (hands and knees) and a “downdog” bend – repeating the sequence as needed. Benefits: Gets blood flowing and builds energy during your yoga practice.
- Locust – Laying face-down and raising your chest, arms, lower legs and feet off the floor. Variations include keeping your arms at your sides and hands reaching straight back (think: “Superman” style) or interlacing your hands behind your lower back for even more of a stretch. Benefits: Helps open the chest to combat poor posture or slumped shoulders, which can come from feeling withdrawn or physically closed off – common symptoms of depression.
- Plow – A back stretch that involves laying on your back and reaching your legs and feet overhead, touching your toes to the floor above your head. Benefits: It quiets the nervous system, relieves irritability and serves as a full body renewal.
- Supine bound angle pose – A hip-opening pose where you lay on your back with your feet together and knees apart (think: “butterfly” style). Keeping your hands on your chest and belly helps you focus on breathing and relaxation. Benefits: This restorative pose can relax the mind and body.
The latest yoga/depression research
More than 15 million Americans practice yoga, and there’s increasing evidence of yoga’s physical and psychological benefits.
New research published in Psychological Medicine is the largest study of the yoga/depression connection to date. The study involved 122 adults with moderate depression. Half of them were randomly assigned to try hatha yoga (most forms of yoga practiced in the West), while continuing treatment with anti-depressant medication. After 10 weeks, the yoga group didn’t show significant improvement over the “control” group, but after six months, 51 percent of those who took yoga (about three sessions per week) experienced a 50 percent reduction in symptoms (compared with a 31 percent decrease in symptoms in the non-yoga group).
The takeaway? Yoga may not alleviate depression symptoms right away, but the benefits may build when yoga is practiced regularly over a longer term.
Hundreds of patients report using more than a dozen different forms of yoga as part of their treatment plan. See how patients with major depressive disorder are using yoga and how they rate its effectiveness.
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- Filed Under: Conditions, Depression, Patient Experiences
- Tags: depression, major depressive disorder, MDD, mental health, physical health, treatment, treatment plan, yoga, yogi