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Therapy or drugs?

Medical debate: therapy or drugs?

May 8, 1996
Web posted at: 6:45 p.m. EDT

From Correspondent Janine Sharell

NEW YORK (CNN) -- Increasing rates of depression and a high volume of antidepressant prescriptions have raised concerns that depression sufferers are taking medication when therapy may be more effective.

The majority of the new cases relate to women, who for some reason tend to be more depressed.

"Regardless of education and age, women are more depressed than men ... anywhere from two to five times," psychologist Ellen McGrath says. "We think there are reasons for that. They are mainly cultural, but sometimes they are biological."

McGrath

McGrath, author of "When Feeling Bad Is Good" and head of the American Psychological Association's National Task Force on Women and Depression, notes that nearly 70 percent of antidepressant prescriptions are written for women.

The problem, McGrath says, is that doctors are pressured to cure patients quickly (85K AIFF sound or 85K WAV sound) . Other psychologists, like William Danton and David Antonuccio, agree with McGrath but add another level to their research. They compiled data comparing the use of drugs to psychotherapy in treating depression and found that therapy can be just as successful as medicine.

"What we concluded is psychotherapy is just as effective as drug treatments for depression and has some advantages in terms of preventing relapse," Antonuccio says.

Counter

Some doctors believe that prescription drugs are too experimental to be a truly healthy cure.

McGrath is opposed to medication on the grounds that it is not standardized or adequately tested.

"About a third of the time, the antidepressants don't work and you need to do a lot of experimenting to get the right combination," McGrath says.

Dr. Michael Norden concurs. "The brain is extremely complicated, obviously, and so we're a long way off from knowing the full mechanism of action of these medications," says Norden, the author of "Beyond Prozac."

Norden is exploring alternate treatments for depression that can mimic the way Prozac and other drugs interact with the brain.

Chief among Norden's questions is why this generation more than any other seems to need drugs like Prozac. His theory includes the factors of diet, sleep patterns and sunlight exposure (145K AIFF sound or 145K WAV sound).

For now, Norden grudgingly says that drugs are among the most reliable and effective treatments doctors have, but he and other doctors urge combining drugs and therapy for the maximum results.

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