4/27/2022: Antidepressants in the News

Antidepressants in the News 

I enjoy reading the Well section of the NYT (full disclosure – you have to be an NYT subscriber because it’s behind their paywall). Their writers do a great job of translating medical science into easy to understand prose, and they are quick to bring new findings to a wider audience.

This week, the Well blog had an article titled “How Much Do Anti-Depressants Help, Really?”. Leading headline aside, it discusses a meta-analysis published in PLOS ONE that concluded that long term use of antidepressants do not improve quality of life. BUT WAIT. Like with most science, it’s a disservice to walk away after a sound bite. There are a ton of caveats with that finding.

For example:

1. They didn’t exclude people who had already been on antidepressants. The biggest improvement in taking antidepressants comes at the beginning, when you start to feel better from the medication’s effect. You would expect to have a plateau after you’d been on it for 4-6 weeks, but the plateau would be at a higher level of mood and functioning than prior to starting the medication. Since they didn’t exclude these patients, the conclusion is not entirely a fair one to decide if antidepressants are efficacious long term.

2. They didn’t address the level of depression patients had. Severe depression sometimes does not respond well to SSRIs alone; mild depression may not need medication at all. This study lumped everyone in together.

There are numerous studies that show that antidepressants DO work. In my clinical experience, antidepressants DO work. Not every antidepressant works for every patient. Not everyone needs antidepressants long term. Not everyone with depression needs a prescription. But I really hate to see news articles with headlines like “How Much Do Anti-Depressants Help, Really?” People suffering from depression already get so much pressure to just pull themselves up by their bootstraps and decide to be happy that it’s already a hurdle to ask for help with medications. So for those of you with depression – ask for help. It may or may not include a prescription for an antidepressant, but they remain an important tool in the toolbox and have provided relief for many people.

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We Made a Wise Patient Strava Group!

If you record your exercise on the Strava app, join our new Wise Patient Strava group! Anyone on Strava can join: https://www.strava.com/clubs/wisepatient.
Dr. Warren and Dr. Beda are on there, as well as former health coaches, patients, and friends. Let us all cheer each other on, no matter what your speed, distance, or sport.

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A Farewell Letter from Ali

Well… all good things must come to an end.

Thank you for trusting and allowing me to be a part of your care during my short but memorable time at Wise Patient. Thank you to the WP team for letting me share my passion for environmental and human health with you all! If you ever feel lost trying to understand what you can do to help mitigate climate change, start first by nurturing your relationship with the earth.

“People often ask me what one thing I would recommend to restore relationship between land and people. My answer is almost always, “Plant a garden.” It’s good for the health of the earth and it’s good for the health of people. A garden is a nursery for nurturing connection, the soil for cultivation of practical reverence. And its power goes far beyond the garden gate—once you develop a relationship with a little patch of earth, it becomes a seed itself. Something essential happens in a vegetable garden. It’s a place where if you can’t say “I love you” out loud, you can say it in seeds. And the land will reciprocate, in beans.”― Robin Wall Kimmerer

Wishing you all great health and a rekindling of what brings you joy and happiness,

Ali Gibbs