Dr. Michael Thase is one of the leading psychopharmacology experts in the world and an expert on mood disorder (depressive disorders, bipolar disorders). He is also a member of the Editorial Board of Simple and Practical Mental Health. You can read his brief bio HERE.
In this interview with Rajnish Mago, MD, of Simple and Practical Mental Health, he discusses whether antidepressants work and which ones work better than others.
In Part one of this interview, Dr. Thase comments on the following questions:
– Why did a meta-analysis about the efficacy of antidepressants that was published in 2018 get so much attention by laypersons and in the medical media?
– Do antidepressants work better than placebo? If so, by how much?
– Why do most studies of antidepressants provide only limited information?
– Are meta-analyses reliable? What are some of their potential limitations?
– Is vortioxetine more efficacious than other antidepressants?
– What should we make of the fact that the Cipriani et al. paper includes in its Conclusions some results that were not statistically significant?
– Has the Cipriani et al. paper changed his clinical practice in any way?
In Part two of this interview, Dr. Thase comments on the following questions:
– In looking at the efficacy of antidepressants, shouldn’t we look at the cumulative efficacy after a series of trials (if needed) of antidepressants?
– Also, isn’t the efficacy of antidepressants even more impressive in preventing relapse and recurrence than in the acute phase?
– What is the role of psychotherapy in treating depressive disorders?
– For which patients with a depressive disorder should we NOT prescribe an antidepressant?
– How often does he NOT prescribe an antidepressant to a person with a depressive disorder?
– If psychotherapy is tried first, at what point should an antidepressant be considered?
– Should ALL patients with depression receive both medication and psychotherapy?
In Part three of this interview, Dr. Thase comments on the following questions:
– Which four antidepressants does he prescribe most often and why?
– If he developed major depression, which antidepressant would he himself take? What do you think he will say?
Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JPT, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JPA, Geddes JR. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018 Feb 20. pii: S0140-6736(17)32802-7. PubMed PMID: 29477251.
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