Depression

True Healthcare Reform Must Integrate Mental Health into the Mainstream

 

August 1st, 2009

About 15 millions Americans are suffering through depression every year; one in every Six Americans suffers from depression in their life time.  The most common treatment is a combination of therapy and medicine.

A bigger challenge is that many who need the help most also have the difficulty on trusting their medicine.  They justify that none of these work.  Quite often those taking the medications and therapies are not the ones who need it the most.

On top of these problems, the uncertainity in the effectiveness of these medications enhances the belief.  “There’s no clear evidence that one antidepressant is more effective than another,” said Dr. Ian A. Cook, director of depression research at UCLA’s Semel Institute for Neuroscience and Human Behavior.  “there is not a good way to know what medication is going to be the best for your patient,” said Dr. Raymond J. DePaulo Jr., a professor of psychiatry at the Johns Hopkins University School of Medicine.   Devon Schuyler of LA Times, says that cost has become less of a concern now that most antidepressants are available in generic form for less than $20 a month, so the decision usually comes down to side effects.

August 1st, 2009
by Dr. Ravi

About 15 millions Americans are suffering through depression every year; one in every 6 american suffers from depression in their life time.  The most common treatment is a combination of therapy and medicine.

A bigger challenge is that many who need the help most also have the difficulty on trusting the medicine.  They justify that none of these work.  Quite often those taking the medications and therapies are not the one who need the most.

On top of these problems, the uncertainity in the effectiveness of these medications enhances the belief.  “There’s no clear evidence that one antidepressant is more effective than another,” said Dr. Ian A. Cook, director of depression research at UCLA’s Semel Institute for Neuroscience and Human Behavior.  “there is not a good way to know what medication is going to be the best for your patient,” said Dr. Raymond J. DePaulo Jr., a professor of psychiatry at the Johns Hopkins University School of Medicine.   Devon Schuyler of LA Times, says that cost has become less of a concern now that most antidepressants are available in generic form for less than $20 a month, so the decision usually comes down to side effects.

There are two types of medication, according to LA Times:  selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft and serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Effexor and Cymbalta. Doctors starts with SSRIs which have less risk of side effects and then move to SNRIs.

About 60% of the pateints get some benefit from the first drug they try.  Compounding the problem of finding the right medication is the fact that these tend to take significant of time to show any impact.  Many patients who do not see the impact soon enough, tend to stop taking them.  Another problem is also the side effect due to stopping of these medications.

As the healthcare reform is being debated, it is important to provide focus on mental health.  We all know that overall wellness is a combination of mental, physical, and spiritual health.

If we really need an effective reform, we must also integrate physical healing with mental healing.  And oh, we do need good comparative study.

©2009  The Healthcare Transformation

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