Posted by Anyuser on February 5, 2002, at 12:06:43
In reply to Read an article: getting really pessimistic...., posted by Anna Laura on February 4, 2002, at 22:56:40
The article you cite is a letter from Giovanni Fava criticizing a more substantive article written by Gavin Andrews. I suggest you read the Andrews article, which is much more encouraging. Gava's first footnote is linked to it, and here's the url: http://bmj.com/cgi/content/full/322/7283/419. Andrews's article encourages the medical community to manage depression as a chronic disease. Here are Andrews's summary points:
1. The burden of depression is not being reduced.
2. The episodic nature of depression and the acute response to treatment means that episodes seem easy to treat.
3. They can be if patients comply with drug and cognitive therapy regimens.
4. The main problem is the next recurrence, if patients do not to come for treatment at all.
5. To reduce the burden of depression, we argue for a chronic disease management model.
6. We should manage depression proactively to ensure long term compliance with treatment.
That's not so scary. We already know all that: depression is recurrent and chronic. I would add a point that Andrews doesn't make: we all know vulnerability to depression increases with age.
Fava's point is an attention-getter: he says antidepressants make depression worse. I worry about that, but for now I don't think there's much science to back up Fava. Note the only person he cites to back up the two scariest sentences in his letter is: himself! Incidentally, I cannot find Fava's articles (the ones he cites in his letter) anywhere on the internet.
You say your doctor "didn't believe in drugs." If I were you, I'd get a new doc.
poster:Anyuser
thread:92902
URL: http://www.dr-bob.org/babble/20020131/msgs/92961.html