New Options for Severe Depression 1/9/02 ?

Q.When SSRIs became available a few years ago they were heralded as an important step for depression treatment. While they did offer a solution for the majority of patients, they still weren't the answer for everyone, though, says David L. Dunner, MD, co-author of the Remeron study, and director of the Center for Anxiety and Depression and professor of psychiatry and behavioral sciences at the University of Washington Medical Center in Seattle.

A.switching drugs often has its downside, something called "discontinuation syndrome." It's a real concern, Dunner says. "Symptoms can include anxiety, numbness and tingling, weird dreams, agitation, depression, flu-like symptoms." The symptoms are not dangerous, and do eventually go away on their own, but they are uncomfortable nonetheless. That's where Remeron comes in. It has been used extensively in Europe but was released only recently in the U.S., Dunner tells WebMD. "[Remeron] is one of a new generation of psychiatric drugs that work by different mechanisms and have different side effects than SSRIs," he says. "We showed it was safe and it worked," he tells WebMD. "It's another important option for patients." Dunner and his colleagues found that Remeron was significantly effective in reducing depression, after patients had failed to respond to an SSRI, and that nearly half of all patients had "considerable improvement in depression," says Dunner. The reason for the short-term improvement could lie in the sedating effects that Buspar has, Dunner says. "So if patients are anxious and sleepless, you may see changes in depressive symptoms -- that's why they saw an effect in the first week. But the lack of sustained effect is troubling."

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