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ACP-ASIM issues guidelines for precribing antidepressant drugs

New guidelines for drug treatment of depression, released today by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), say that both older and newer antidepressant drugs are effective, and that St. John's wort may be effective in treating mild depression in the short term, but with caveats. "Depression strikes all ages, races, and income brackets. It's a very painful but very treatable illness, and there are many options available. It's important to talk to your doctor to determine the treatment that's best for you," says Herbert H. Waxman, MD, ACP-ASIM senior vice president for education.

To expedite doctor-patient discussions about depression, ACP-ASIM has developed a patient education brochure that is available by calling 1-877-828-2525. The information is also available on an ACP-ASIM Web site: www.doctorsforadults.com.

The guidelines, "Pharmacologic Treatment of Acute Major Depression and Dysthymia," and a background paper, "A Systematic Review of Newer Pharmacotherapies for Depression in Adults: Evidence Report Summary," are published in the May 2 issue of Annals of Internal Medicine.

The older drugs for treating major depression, such as tricyclics, and the newer drugs, such as selective serotonin reuptake inhibitors (SSRIs), have different side effects, interactions and costs. Patients taking tricyclics need dosage monitoring, and tricyclics can be fatal in overdoses. Tricyclics, most of which are available generically, are cheaper per pill. SSRIs and other newer drugs are not currently available in generic form and are generally more expensive. SSRIs are easier to take and do not require blood testing. Physicians should discuss with patients the uses and side effects of appropriate drugs, the guidelines say, and together, doctor and patient should come up with an antidepressant that fits the patient's needs.

ACP-ASIM recommendations about St. John's
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Contact: Susan Anderson
sanderson@mail.acponline.org
215-351-2653
American College of Physicians
1-May-2000


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