Drugs vs. Talk Therapy: Lecture Notes

LECTURE NOTES.

DRUGS VS. TALK THERAPY
3,079 readers rate their care for depression and anxiety. From Consumers Reports: October,2004.

1. Some of our results confirm those of smaller, placebo-controlled clinical trials.
Other findings--such as the effectiveness of specific drugs and talk therapy, and the side effects of antidepressants--capture information that clinical trials cannot, and challenge some of their findings.


2. >80% of respondents said they found treatment that helped. Talk therapy rivaled drug therapy in effectiveness. A combination of talk therapy and drugs often worked best. But “mostly talk” therapy was almost as effective (as drug treatment) if it lasted for 13 or more visits.

3. Psychotherapy delivered by psychologists and clinical social workers was perceived as effective as that given by psychiatrists. Pscyhopharmacology from primary-care doctors (PCP) was as effective (as from psychiatrists) for people with mild mental health issues; but less so (compared with psychiatrists) for people with severe mental health issues.
(Independent studies have documented the less effective mental-health treatment delivered by primary-care doctors.)
"Mostly drugs” was the type of therapy described by almost half of those who saw only a primary-care physician and 38 percent of those who saw a psychiatrist.


4. Drug therapy relieved symptoms faster than talk therapy, and the majority of people who described their therapy as “mostly medication” also had good outcomes. It can take much trial and error to find the right medication. More than 50 percent of survey respondents who took antidepressants tried two or more drugs; 10 percent tried five or more.


5. The rates of adverse drug side (toxic) effects were much higher than those noted on the medications' package inserts:
40% experienced a loss of sexual interest or performance; almost 20% gained weight.