In a significant analysis of various antidepressants' effectiveness in preventing relapses, the drug escitalopram has been identified as the most effective. The study, involving nearly 10,000 patients prescribed different medications for up to a year, was published in The Lancet Psychiatry. Escitalopram outperformed Prozac (fluoxetine) in preventing relapses, with agomelatine and duloxetine following closely behind. While the findings do not suggest that everyone with severe depression should switch to escitalopram, they indicate a promising option for those seeking to prevent relapse. The research was conducted over a period of time, with differences found being modest, necessitating longer studies for further insights. Depression is a common affliction, affecting one in six people in the UK. Treatment and support can lead to recovery, although relapses are possible. To prevent relapse, doctors currently recommend patients stay on antidepressants for at least six months after depression ends, before gradually tapering off. The analysis compared the effectiveness of more than a dozen common antidepressants. While escitalopram was found to be superior to Prozac in preventing relapses, the choice of medication can vary for each individual, according to one of the researchers, Prof Eric Ruhé at Radboud University in The Netherlands.
SUMMARY (CONTINUED):
The study's findings should not be interpreted as a reason for patients to change treatment if they are responding well to their current antidepressant, warns Dr Sameer Jauhar, an expert at Imperial College London. Prof Allan Young from the Royal College of Psychiatrists also emphasizes that while some medicines may have a small advantage over others for longer-term outcomes, the differences are modest and individual factors such as side effects, previous response, and patient preference should be considered when deciding on treatment. Escitalopram, like all medications, can cause side effects including sleep problems, constipation, and weight gain, but not everyone experiences them. The NHS suggests that if escitalopram or a similar SSRI is ineffective or not suitable, doctors may recommend a different type of antidepressant, such as an SNRI. Older tricyclic antidepressants are less commonly prescribed now. The mental health charity Mind emphasizes the need for people to have access to clear information about the potential benefits and side effects of antidepressants, as well as other forms of support, including talking therapies and mindfulness.
SUMMARY (CONTINUED):
It is common for people to need to try more than one medication before finding the right treatment that works for them, according to Mind. The charity's website provides information to help compare different antidepressants. SSRI antidepressants, like escitalopram, sertraline, and fluoxetine or Prozac, are often recommended as the first drug of choice in many medical guidelines. These drugs increase serotonin, which is linked to mood. However, the choice of medication can vary for each individual, according to Prof Eric Ruhé at Radboud University in The Netherlands. He suggests that this study can help inform decisions made by prescribers and patients together: if you start an antidepressant, choose one that not only helps you get well, but also keeps you well.