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Pharmacy Link

WHAT PERCENTAGE OF PATIENTS WHO ARE TAKING PROZAC ARE REALLY HELPED BY IT? WHAT SHOULD PATIENTS DO IF DEPRESSION HAS NOT BEEN RELIEVED BY PROZAC?

Approximately 65% to 70% of depressed patients who take Prozac find that their symptoms are fully relieved within two to six weeks and that they are able to function normally once again. The other 30% to 35% of patients who don’t respond or who can’t tolerate the early side effects of nausea or insomnia that may occur for a couple of days in the beginning may respond instead to one of the older antidepressants; they may fall into the category of treatment-resistant (to all antidepressants); or they may respond to one of the new antidepressants such as Zoloft, Paxil, Effexor, Nefazodone or an antidepressant still being tested in research clinical trials and not yet on the market.

The other well-tried older antidepressants have similar rates of success, but side effects are almost always present and bothersome.

Many psychiatrists recommend augmentation treatment by adding lithium or a thyroid hormone, Cytomel. Oftentimes the addition of one or both of these drugs to the antidepressant boosts the patient out of depression. Both drugs are considered step-up treatments. However, if the psychopharmacological approach does not work, consider psychotherapy.

In extreme cases, in which the patient is suicidal, losing weight, or totally unresponsive to any of the above medication, electroconvulsive therapy has proved very useful. Despite the negative associations some people have about ECT, it is a proven therapy that rapidly and effectively treat serious depression.

Finally, patients who are treatment resistant to all medications on the market may wish to consider participating in a free clinical research trial on a new antidepressant compound that is being evaluated at a number of universities and clinical research centers.

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