Are Antidepressants Really No Better Than Sugar Pills?

What Patients Should Know

Concerned patients should consult their doctors, especially when it relates to stopping antidepressants. "Never discontinue medication without talking to the doctor about it," the National Institutes of Mental Health (NIMH) stresses. "Although antidepressants are not habit-forming or addictive, abruptly ending an antidepressant can cause withdrawal symptoms or lead to a relapse."

Individuals vary widely in how they respond to antidepressants. The drugs take time to reach their full effects -even up to six weeks. And some people go through three or four different drugs before they find one that works for them. The drugs can be a lifesaver for some but might not the best choice for others.

Other treatment options:

  • Psychotherapy. Also known as talk therapy, this could be the best way of treating mild to moderate depression for many individuals, the NIMH says. A 2005 study even found that therapy worked as well as antidepressants for moderate and severely depressed people. To improve your chances of success, approach psychotherapy with an open mind, a willing spirit and a commitment to attending regularly.
  • Exercise. Regular physical activity is a chemical-free wonder drug. Aerobic (cardio) activities such as walking, dancing, tennis, basketball and swimming are typically most effective at relieving symptoms of depression.
  • Positive coping methods. Many people find it helpful to write in a journal, attend a support group in person or online, talk to a friend or enjoy a hobby.
  • Adequate sleep. Many depressed people experience sleep disorders. Approaches can include methods such as sticking to a regular sleep schedule, avoiding daytime naps, restricting caffeine and using earplugs or a white-noise machine.
  • Not abusing drugs or alcohol. Those habits increase the risk of depression and can worsen symptoms and interfere with treatments.
  • Nutrition. A balanced diet can lift mood and enhance overall health and coping abilities. This includes plenty of vegetables, fruits, whole grains and beans, adequate water, lean protein and "good" fats such as olive oil, nuts, seeds and fish. Make sure to cut back on other fats and processed starches and sugars too.
  • St. John's wort. This herb has long been a popular remedy for depression. Studies of the herb have shown conflicting results, with positive effects on mild to moderate depression, but no effects on major depression. People taking St. John's wort should be aware that it has numerous drug interactions, including with anticoagulants and birth control pills.

Depression is highly treatable. A combination of drugs, therapy, exercise and other methods may even out your mood. Let the latest controversy over antidepressants start a dialogue with your doctor about what's the best treatment for you.

Reviewed by David Slotnick, M.D.

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