Facts on Access to Medications for People
with Depressive, Bipolar and Anxiety Illnesses

The Evidence Base for Newer Anti-Depressant Medications

"Over the past decade, the selective serotonin reuptake inhibitor (SSRI) class of anti-depressants has largely replaced the older and more problematic tricyclic anti-depressants, based in large part on the safety and side effect considerations."

Steven E. Hyman, M.D., Former Director, National Institute of Mental Health

  • The newer class of anti-depressants, called SSRIs, has been hailed as a breakthrough in the treatment of depression by scientists and physicians.
  • A very large body of research has been conducted on individual anti-depressant medications, and on comparisons between classes of anti-depressant medications as well as between different drugs within the same class of anti-depressant medication.

  • The evidence base is moderately strong that the newer, and consequently more costly, anti-depressants (SSRIs, selective norepinephrine reuptake inhibitors (SNRI), and atypicals) are generally more effective than older anti-depressants (tricyclics). Newer medications are also safer and have both fewer side effects and less severe side effects.
  • The introduction of SSRIs significantly reduced the number of patients who had stopped taking their medication compared to those who were given older medications, according to a study of 2,600 patients with depression who received prescriptions for anti-depressant drugs.
  • The cost of treating major depression in the U.S. decreased by 25 percent from 1991 to 1995, a trend that was driven largely by the development of increasingly effective anti-depressant medications.
Newer medications are also safer and have both fewer side effects, and less severe side effects.
  • Anti-depressant medications represent less than 10% of total direct costs of depression.
  • A recent landmark government-financed study has found that anti-depressants are effective in treating depression in children and adolescents. The study, called the Treatment for Adolescents with Depression Study (TADS), involved youths between the ages of 12 and 17. Researchers said that benefits of taking anti-depressants for depressed children far outweighed the risks and that adverse events are extremely rare. The study also found that the combination of medications and talk therapy offer the best results for children with moderate and severe depression.

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