Paxil and Other Antidepressants May Treat Only Severe Depression

Columbus, OHWomen who took Paxil while pregnant, despite evidence that Paxil may cause birth defects, may now be wondering if it was worth the risk, especially if they took Paxil for mild depression. A recent study suggests that antidepressants are only effective in cases of severe depression.

Published in the Journal of the American Medical Association in January, the study found that antidepressants were no more effective than placebos in treating people with mild depression. The implication is that for these patients, there are much better ways to treat their depression, including regular assessment and discussions with a professional.

Researchers evaluated six drug trials involving people with mild to severe symptoms of depression. The patients took either Paxil, a selective serotonin reuptake inhibitor, or imipramine, a tricyclic. Researchers found that patients scoring 25 or higher on a scale of severity of depression experienced a steeper reduction in symptoms when they took the antidepressants as compared with those who took placebos. However, patients who scored less than 25 on the severity scale gained little or no benefit from the antidepressants as compared with the placebo.

Other medical groups have advised that pregnant women with mild to moderate depression try other forms of treatment before using antidepressants. This is due, at least in part, to a suggested link between the use of antidepressants while pregnant and an increased risk of congenital heart defects in babies.

A report entitled "The Management of Depression During Pregnancy: A Report from the American Psychiatric Association and The American College of Obstetricians and Gynecologists" suggested that pregnant women who want to avoid taking antidepressants may find psychotherapy helpful.

However, those organizations noted that antidepressants may still be warranted for some women who experience suicidal or psychotic symptoms. They also noted that women with depression who do not take antidepressants face other consequences, including poor prenatal care and pregnancy complications.

According to the New York Daily News on January 6, there were more than 164 million prescriptions written for antidepressants in America in 2008, totaling almost $10 billion in sales.