- A US expert has put forward the theory that some of the
most powerful drugs used to treat depression may actually exacerbate the
condition in the longer term.
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- In clinical medicine, the likelihood that a specific
treatment, while alleviating the symptoms of disease, may aggravate its
course has often been evaluated. In a soon to be published paper, Dr Giovanni
Fava, who has joint appointments with the University of Bologna in Italy
and the State University of New York, raises some concerns about the potential
"sensitising" effect of antidepressant drugs on depression.
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- Some clinical observations may generate this suspicion,
Fava argues. He cites the "catastrophic" long-term outcome of
depression treated with antidepressant drugs, certain paradoxical effects
of antidepressants that have been described, and the issues related to
tolerance, resistance, withdrawal and dependence - particularly associated
with the newer antidepressants.
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- These data, he believes, may suggest the possibility
that antidepressant drugs are effective in treating depression in the short
term, but may cause serious problems later. This hypothesis has pharmacological
and neurobiological explanations, he says, even though there is no robust
data to support it. And he adds that if the sensitisation hypothesis was
substantiated, it could revolutionise current treatment of depression,
which heavily rests on the use of antidepressant drugs.
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- Fava bemoans that fact, however, that very few investigators
are interested in testing the hypothesis.
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