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Created on Tuesday, 22 May 2012 17:31

Last Updated on Friday, 01 June 2012 17:58

Written by Dr Ken Gillman

Depression - Post natal (1).

Depression - Post natal (1).

Date Created: 13/02/1999 Last Modified: 11/10/1999 Last Checked: 10/07/2001

The treatment of major depression with drug therapy deserves powerful advocacy to patients and their relatives because drugs almost certainly reduce the number of suicides.

Angst’s 30 year follow up of depression treated with drugs clearly shows the much reduced risks which are, death by suicide:-

• unipolar, treated 7% vs untreated 18%
• bipolar, treated 5% vs untreated 13%

To collude with patients by not advising, and actively advocating, treatment of depression with medication is like expounding exercise, as a sole substitute for drugs, for the control of malignant hypertension.

Long term treatment with antidepressants.

There are remarkably few studies of long term treatment with any sorts of antidepressants. Of the SSRIs there are good studies with sertraline. These show it to be effective in the long term and to have an good side effect profile with few drop outs.

It is interesting to observe that in one of these long term studies, mianserin, which I consider to be an ineffective antidepressant, was not significantly different from placebo in an end of study analysis.