ANTIDEPRESSANTS: Yes, there is a safer and better way

Antidepressants are very powerful agents that can deliver nasty adverse reactions and side-effects.

Take, for example, the SSRIs (selective serotonin reuptake inhibitors), which are the latest family of antidepressants, and include in their ranks Prozac and Seroxat.

Reactions have included hepatitis and liver damage, and tests have shown they can bring on manic attacks, seizures, suicidal tendencies and abnormal bleeding. Overall, up to 20 per cent of people suffering from depression have to stop taking an SSRI because of some reaction such as insomnia, agitation, tremors, anxiety, dizziness, constipation, nausea, diarrhoea, vomiting, impotence and sweating.

A new study reveals that depressed people needn’t go through this trial of fire. Instead, a drug-free approach called cognitive behavioural therapy can be just as effective, but without all the nasty reactions that come with antidepressants.

Researchers tested cognitive behaviour therapy against Seroxat (paroxetine) on a group of 30 patients diagnosed as clinically depressed. Half had between 15 and 20 sessions of cognitive behaviour therapy, while the rest were given Seroxat.

Amazingly, not only did cognitive behaviour therapy relieve the depression, it also affected brain activity as monitored by tomography screening. The patients’ brains showed significant metabolic changes, with increased activity in the hippocampus and dorsal cingulate regions.

One of the researchers, Helen Mayberg, professor of psychiatry at Toronto University, said: ‘Our imaging results suggest that you can correct the depression network along a variety of pathways. Antidepressant drugs change the chemical balance in the brain through effects at very specific target sites. Cognitive behaviour therapy also changes brain activity: it’s just tapping into a different component of the same depression circuit board.’

(Source: Archives of General Psychiatry, 2003; 61: 34-41).