![]() 14 But there is a wealth of medical research on the topic, and studies continue to point to the effectiveness of non-pharmacological therapies for depression.įor patients who have tried several different antidepressants to no avail, other therapeutic interventions such as diet may yield better results. ![]() 12 What’s more, clinicians differ greatly in how they diagnose depression-from using checklists to using “gut sense.” 13 Perhaps due to lack of time or the inherent difficulties of diagnosis, some clinicians are not inquiring much or at all about depression. According to one report, 42% of doctors had a hard time differentiating between unhappiness and clinical depression. In the following video, IFM educator Patrick Hanaway, MD, IFMCP, talks about how a clinician might unravel the root cause of depression by looking at several factors, including levels of vitamin D and other vitamins, amino acids, and minerals-as well as the gut microbiome.Ĭlearly, variable reports on the efficacy of antidepressants, 8,9 combined with the high prevalence of depression, 10-11 have left many clinicians challenged about how to help patients. The functional medicine model emphasizes a multi-pronged approach to health and wellness, engaging patients in a therapeutic partnership that recognizes that the current conventional paradigm does not optimally address the needs of patients with depressive symptoms. How can you get to the root cause for an individual patient, and what adjunct therapeutic interventions might improve outcomes? The Path Forward: Complementary Therapies When the cycle of depression continues for your patients and they still do not find relief, the clinical encounter can seem as hopeless as the patient feels. Many factors can impact the efficacy of given treatment, but with lower rates of patient engagement to medication therapy, it may not be as effective as standalone treatment. Specifically, the reports found that SSRIs and SNRIs led to a greater number of study withdrawals due to adverse events, and duloxetine increased the risk of falls. 7 Antidepressants included in the study were selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), bupropion, mirtazapine, trazodone, vilazodone, and vortioxetine. 6įor those who adhere to antidepressant therapies, treatment of the acute phase of major depressive disorder (MDD) leads to a greater number of adverse events in patients 65 and over, according to a 2019 systematic review. ![]() Another study showed that antidepressant non-adherence is common among veterans, with ineffectiveness and avoidance of side effects frequently reported as reasons. 5 Forgetfulness was the main reason for missing doses. 5 A 2017 study found that 68% of the females surveyed did not follow their prescribed antidepressant therapy. 4 Non-adherence to antidepressants is also common. In fact, a major study published in 2018 found that only about a third of patients diagnosed with depression actually start treatment. 3ĭepression is a multifactorial condition that may have several different antecedents and triggers unique to each individual, and as such, a singular focus on antidepressant medication therapy may not be the optimal approach. 1 Depression is most acutely seen in females and young adults (aged 18-34) 2 however, the prevalence among children and adolescents has significantly increased in recent years. Research from the World Health Organization estimates that during the first year of the pandemic, the prevalence of two common mental health disorders, anxiety and depression, increased 25% across global populations. Prior to the COVID-19 pandemic, mental health disorders were considered one of the leading causes of health-related burden worldwide.
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