People suffering from major depression can be helped just as well by facing up to and solving their problems as by taking antidepresssants.

Instead of reaching for the prescription pad, doctors should consider referring their patient to a therapist or counsellor. A series of six or seven sessions could have the same positive effect as a drug, without its side effects and potential dependency. Counselling also gives the patient the satisfaction that he has worked through the problem for himself.

Researchers from Warneford Hospital, Oxford studied 91 patients who met the criteria for major depression: they had been depressed for at least two weeks and had significant impairment of functioning.

Problem solving sessions were compared with the antidepressant amitriotyline or simply a placebo. The sessions involved listing the patients’ problems, and helping them to identify and choose between possible solutions. In all, they attended about seven sessions, lasting a total of four hours.

Whereas the placebo had no effect, problem solving was a slightly better option than the drug with 18 of the 30 patients considered to be recovered, against 16 of 31 patients in the drug group.

!ABMJ, February 18, 1995.

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Written by What Doctors Don't Tell You

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