Several new medications for the treatment of depression have been introduced over the last 20 years. What has been missing is any consistent data about the effectiveness of these "second-generation" antidepressants.
A team of researchers have now reviewed 117 controlled trials to compare second-generation antidepressants for the acute treatment of unipolar major depressive disorder in adults. The medications were reviewed for efficacy (effectiveness), patient acceptability, and cost.
Researchers reviewed 117 controlled trials of second-generation antidepressants.
These trials had a total of 25,928 participants.
The antidepressants compared were:
Medications were judged by the proportion of patien...
How long does withdrawal from Zoloft take, and are there any serious side effects that will damage the brain? As far as we know, SSRI withdrawal does not cause permanent damage. But it feels like a bad flu, so it's not fun. The withdrawal is based on two factors: the half-life of the drug and the "potency" of the drug. The short half-life drugs such as Paxil tend to produce worse withdrawal than longer half-life drugs, such as Prozac. Many psychiatrists take advantage of the long half-life of Prozac and prescribe a single dose to treat withdrawal from the other SSRIs. Importantly, there is cross-coverage from other drugs. Stopping Paxil cold will produce withdrawal, but switching Paxil to Zoloft, for example, should protect you from it. In addition, this withdrawal effect is (mostly) limited to serotonergic antidepressants. Wellbutrin is not expected to have this effect.
I recently spoke with a friend with diabetes who had just started Prozac. He was amazed to find he was having repeated hypoglycemia within days after starting the drug, and had to cut back on his insulin doses. He obviously wondered if it were somehow due to Prozac.
Prozac has been a wonder drug for the treatment of depression, but it has a possible effect on diabetes that has not been widely recognized. Prozac, a brand name for the drug fluoxetine, was introduced in the 1980's, and was the first in a class of antidepressant medications called SSRIs (selective serotonin reuptake inhibitors). It turns out that Prozac (and other SSRIs) have a possible effect of concern for people with diabetes: they can lower blood glucose enough to require downward adjustment of medications taken for control of diabetes.
I went to the drug's label, as posted at the FDA website. The possibility of hypoglycemia when on Prozac has been in the Prozac label for years. It currently reads :&...
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