A recent article in the American Journal of Psychiatry looks at depression and how it is treated. The study discussed in the article, the STAR-D trial, looked at the treatment of depression with the drug Celexa in 2,876 patients. The STAR-D trial found that Celexa is effective, which is no big surprise, but it also found that the patients who went back to the doctor regularly for medication adjustments (what the study called “measurement-based care procedures”) had more improvement that those who did not.
This helps to confirm what many doctors know from experience – that the first dose of an antidepressant seldom does the trick. Almost always, the medication has to be adjusted several times to arrive at the optimum dose.
It is important that people who seek treatment for depression do not give up. If the first dosage dose not work, the medicine may have to be adjusted. Or it may be necessary to try another medication.
It is my experience that patients who seek treatment for depression and anxiety often expect too much too soon from the medication. They think popping one pill will turn their lives around, and this is simply not the case. Antidepressives do work, and study after study has shown that, but making them work requires a little effort. If the medication does not seem to be working, or is working a little but not enough, it is vital that the patient discuss this with his doctor. With the proper re-evaluation, a good doctor can refine the treatment until the patient get the results he is looking for.