My own sense, based in part on my own personal experience, as well as that of patients I have treated, is that antidepressants can definitely work for milder depression—not for everyone, but for many. Why, then, the debate and apparently contradictory findings?
USAToday.com had this article: Number of Americans taking antidepressants doubles. (It’s mainly a summary of a study that’s in the Archives of General Psychiatry.) There are a lot of interesting numbers documented in this piece:
- By 2005, 10%, or 27 million Americans were taking antidepressants.
- About 80% of the patients were treated by doctors other than psychiatrists.
- Half of those taking antidepressants were not being treated for depression.
- During the study(1995-2005), spending on direct-to-consumer antidepressant ads increased from $32 million to $122 million.
The most concerning data to me was that “among users of antidepressants, the percentage receiving psychotherapy fell from 31.5% to less than 20%.” I can’t tell from the article if this has happened because more people are using antidepressants for issues unrelated to depression, but the article does state that the main reason why people aren’t seeking therapy is because of insurance issues. In any case, other research has suggested that therapy is an integral part of a long-term treatment plan (This article in NYTimes, for instance, is about the effectiveness of long-term therapy in bipolar depression). It’s sad to think that many aren’t getting the treatment that they know they need because of issues related to cost.
“If your anti-depressant only isn’t enough, Ask your doctor about Abilify,” says that soothing male voice on that commercial about Abilify, a drug that was approved for add-on treatment for major depression in 2008. Suppose your doctor does say, “Abilify may be right for you!, then the starting dosage that s/he probably wrote on that little piece of Rx paper should be between 2-5mg. That is the recommended starting dosage when taking Abilify as an adjuvant treatment.
The advertisement makes it look as though the working mother or the Union dad could go back to work again feeling fine once they get this help. But at what cost, financially speaking?
$485.95. That’s the cash price for a 30-Days worth of Abilify at 2mg. The price obviously goes up as the dosage is raised.
If you have health insurance with prescription benefits, congratulations! You will likely just pay the copay that is significantly less than the face value. But we are not all insured. In a time when over 40 million Americans are uninsured and who knows how many are under-insured, will they even be able to afford Abilify, even if this is exactly what works for them? The hope that there is a treatment out there to help you flashes over and over again on screen. Yet this mere possibility itself may be attainable to you only if you have the financial ability first.
Perhaps that voice-over guy in the commercial should say a little disclaimer: We’re sorry. If you are not insured, this advertisement does not concern you, unless you’d like to trade in your house payments for these little green pills.
Symbyax, a combination drug of Zyprexa and Prozac, has been approved today by the FDA for treating treatment-resistant depression. According to Eli Lilly, the makers of this new pill, it’s the first approved drug for treatment-resistant depression. Symbyax had been approved for use in bipolar disorder a few years earlier.
I wonder if Symbyax would be another option for anyone who had failed before with Zyprexa and/or Prozac by itself.