Teste ao sangue ajuda a escolher medicação para depressão

https://www.cnn.com/2016/09/26/health/blood-test-depression-treatment-antidepressants/index.html
Citando:
"According to a study, an analysis of blood samples can highlight high levels of inflammation in a patient and help predict which drugs may not be effective. Other recent studies have found a link between increased inflammation and lower success rates from treatment.

Identifying this increase up front can help predict which people may need more aggressive treatment early on.

Currently, treatment for depression involves a process of trial and error, with doctors prescribing a particular drug for periods of up to 12 weeks and monitoring patients for any improvement. If no response is seen, a new drug, or combination of drugs, is tried until one is found to be effective.

"If [patients] don't get better, they just switch drugs and then switch again with hope that one will work," said Carmine Pariante, professor of biological psychiatryat Kings College London, who developed the test and led the study."

Uso recreativo de Tianeptine e mortes?

Anti depressivo descoberto nos anos 60, e com funcionamento similar (abuso, sintomas abstinência) aos opiáceos (não aprovado nos EUA) causa toxicidade em uso recreativo:
https://www.cnn.com/2018/08/03/health/tianeptine-antidepressant-poison-control-cdc-study/index.html

Citando:
"From 2014 through 2017, there was an increase in US poison control calls related to the intentional abuse and misuse of tianeptine, an unapproved antidepressant drug, the US Centers for Disease Control and Prevention said in a report on Thursday.

Tianeptine, marketed as Coaxil or Stablon, is used as a prescription antidepressant in Europe, Asia and Latin America. In the US, it can be purchased on the Internet, even though the US Food and Drug Administration has not approved its use.

There have been reports that recreational abuse might result in severe side effects including vomiting, confusion, coma and kidney failure. The drug can be lethal in rare cases."

Antidepressivos e solidão na terceira idade?

Medicar a solidão?
https://www.thetimes.co.uk/article/doctors-using-antidepressants-to-treat-epidemic-of-loneliness-dlj9dr73s

Citando:
"

Doctors using antidepressants to treat epidemic of loneliness

One in five people over 60 were prescribed the pills last year

Older people are twice as likely to be prescribed antidepressants as twentysomethings, with concerns growing that doctors are using drugs to combat emotional problems and “medicalising” loneliness.

Figures obtained by The Times suggest that Britain is suffering from an “epidemic of mismanaged distress”, with antidepressant use rising across the country and millions of people stuck on the drugs for the long term.

NHS data shows that 525,970 people aged 18-24 were prescribed an antidepressant last year, 11 per cent of the age group. This rises to 2,794,451 aged 40-59, 19 per cent of the age group, and 2,578,454 over-60s, or 20 per cent.

According to the World Health Organisation, about 5 per cent of all adults are thought to have depression at any one time…"

Álcool como anti-depressivo (auto-medicação)?

http://www.medicaldaily.com/depression-alcohol-has-same-effects-rapid-anti-depressants-study-says-399568
Citando:
"Because of the high comorbidity between major depressive disorder and alcoholism there is the widely recognized self-medication hypothesis, suggesting that depressed individuals may turn to drinking as a means to treat their depression," she said in a press release. "We now have biochemical and behavioral data to support that hypothesis."
Raab-Graham cautioned, however, that relying on the intoxicating substance can still pose a threat.
"There's definitely a danger in self-medicating with alcohol," she added. "There's a very fine line between it being helpful and harmful, and at some point during repeated use self-medication turns into addiction."

Anti-depressivos ineficazes em jovens - Estudo

Sabiam desta?
"(...)only a limited amount of research has been done on antidepressant use in children and teens."
Dados os efeitos secundários é surpreendente que sejam tão receitados a jovens.


http://www.cbsnews.com/news/most-antidepressants-ineffective-in-teens-study/
Citando:
"The findings show that out of 14 antidepressants, only fluoxetine (sold under brand names Prozac and Sarafem) was more effective at relieving symptoms of depression in young people than a placebo pill. In contrast, taking venlafaxine (Effexor) was associated with an increased risk of suicidal thoughts and suicide attempts when compared to a placebo and five other antidepressants."
"

Uso off-label de anti-depressivos justifica aumento explosivo do uso?

Estudo usou campo de BD que indica o motivo da prescrição.
A lista dos 8 principais usos off-label está no estudo (inclui insónias, ansiedade, enxaqueca e outras "parvoíces").


Detalhes:
http://m.huffpost.com/us/entry/reasons-people-are-taking-antidepressants_us_57472146e4b03ede441411a6


Outro dado "precioso" é que o uso pediátrico é off-label. Citando:
"Many off-label uses are backed by scientific evidence from clinical trials, just not full government approval, as the list above demonstrates. Off-label drug use is also common in certain populations, especially among children, because most drugs prescribed to pediatric patients were never tested in children. This makes many pediatric prescriptions necessarily off-label."

Eficácia de anti-depressivos vs. técnicas como o Mindfullness

A técnica do Mindfulness parece ser tão eficaz como o uso de anti-depressivos para evitar recaídas na depressão:
http://www.cbc.ca/news/health/depression-relapse-mcbt-1.3555884


PS. Só não dá tanto dinheiro a uma certa indústria.

Anti-depressivos em jovens e risco de suicídio (e agressividade)

Estudo recente publicado no BMJ é agora questionado:
http://www.irishexaminer.com/ireland/drug-link-to-child-suicide-queried-by-expert-378817.html


Citando:
"The study, published in the British Medical Journal, examined clinical study reports of 70 trials with 18,526 patients.
The researchers from Denmark found no significant link between antidepressants and suicide and aggression among adults but, in children and adolescents, the risk doubled.
“We suggest minimal use of antidepressants in children, adolescents and young adults as the serious harms seem to be greater and as their effect seems to be below what is clinically relevant,” the authors wrote."