Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.

About one in every six adults experiences depression at some point in his or her life. The good news is that depression can be treated to give you a better quality of life. But finding the right treatment that fits your needs can sometimes be tricky.

The most common treatments are antidepressant drugs, counseling, or a combination of the two. If you or a loved one is prescribed a drug to treat depression, you'll want to understand its benefits and side effects because certain treatments work better for some people than others. For example, 4 of every 10 people will find that the first antidepressant they take may not ease their symptoms, and they'll need to try a different drug to get the best results.

Finding the right antidepressant for you can be confusing and frustrating. To help you work with your doctor or nurse to select the right medicine, my agency, the Agency for Healthcare Research and Quality (AHRQ), developed a guide on antidepressants for adults with depression. In addition to discussing the different drugs used to treat depression, the guide also gives practical information on depression.

Scientists used a type of research called comparative effectiveness to develop the guide, which summarizes the findings of nearly 300 published studies. Comparative effectiveness research focuses on a specific health problem and asks what the pluses and minuses are of the current treatments. These research findings do not make your choice for you. That decision is always left to you and your doctor. But it does provide information that can help you and your doctor make the best choice. For many years, AHRQ has sponsored this type of research through its Effective Health Care Program. The Federal Government is boosting funding for this type of research so doctors, nurses, and patients have good information to make better-informed treatment decisions. In fact, this guide is just one of several consumer guides available from AHRQ.

When it comes to treating depression, any drug's success depends on hitting the right balance between relieving symptoms and minimizing side effects.

Our guide concludes that most people can find an antidepressant that works for them. Six out of 10 people feel better with the first drug they try. However, most people need to take an antidepressant for 6 weeks before they get the full benefit.

The guide also summarizes important information about side effects. It outlines possible side effects—including weight gain, constipation, diarrhea, and sexual problems—and which drugs are more or less likely to cause side effects that may concern you. For example:

  • People who take mirtazapine (sold as Remeron®) gain more weight than people who take citalopram (Celexa®), fluoxetine (Prozac®), or other antidepressants.
  • People who take venlaflaxine (Effexor®) experience nausea and vomiting more often than people who take other antidepressants.

Medicines can improve the quality of your life if you suffer from depression. With research that compares different drugs' effectiveness, you and your doctor can make the best choice for you.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

AHRQ Podcast
Antidepressants  (Transcript)

Agency for Healthcare Research and Quality
Antidepressant Medicines—A Guide for Adults With Depression
http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=10

Effective Health Care Program
http://effectivehealthcare.ahrq.gov/index.cfm

Page last reviewed January 2010
Internet Citation: Comparing Medical Treatments for Antidepressants. January 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/010510.html