[That sounds/reads bizarre, doesn’t it? Surely ‘major’ means that it’s flown past being a ‘mild’ or ‘moderate’ depression… but I digress.]

The study by Fournier et al reduced 2,164 studies to just six worth analysis (by their standards) and found that medication only helps those with severe depression.

There are, of course, limitations with the study – the low number of studies in their meta-analysis being just one, but it does allow the HMHL an opportunity to remind us that exercise, psychotherapy and relaxation are powerful aids in the fight against the black dog for those suffering mild to moderate depression.

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Source:

Fournier JC, et al. “Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-Analysis,” Journal of the American Medical Association (Jan. 6, 2010): Vol. 303,
No. 1, pp. 47–53.

Harvard Mental Health Letter, April 2010 – www.health.harvard.edu

Please see our medical disclaimer.

Recognising that each different type of antidepressant carries with it different types of possible side-effects, the Letter reports on a large meta-analysis which shows two antidepressants having a slight (emphasis on ’slight’) edge of the rest in terms of efficacy and tolerability.

But that is not to say that side-effects are not to be considered when thinking about which drug with which to start treatment.

The study showed that escitalopram (Lexapro, Cipralex) and sertraline (Zoloft) demonstrated a very slight overall edge over other second-generation antidepressants, in terms of efficacy and least amount of side-effects.

Here’s the list of side-effects most likely to be encountered, and the drugs most likely to induce them:

Nausea and vomiting:
venlafaxine (Effexor)

Diarrhoea:
sertraline (Zoloft)

Weight gain:
mirtazapine (Remeron) and paroxetine (Paxil)

Sexual side effects:
paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), with bupropion (Wellbutrin) the least likely of those drugs that did report a sexual side effect to do damage. But bear in mind that dosage can also play a part; my own high dosage of Effexor certainly doesn’t make for wonderful bedroom happiness and a libido like a rugby player!

Conclusion

I know from personal experience that over a course of treatment, or lifetime in my case, a person is likely to move from one to the other as the positive effects of one type start to wane due to tolerance and your practitioner and yourself try a different drug to see if that can kick-start the recovery process again. But keep a watch on the side effects and report anything to your GP or treating physician.