More than two million pounds has been awarded to Bristol University to investigate different ways of treating depression. Four different trials designed to assess a range of treatments will be led by Bristol University in collaboration with other universities.
More than 2.9 million people in the UK are diagnosed as having depression at any one time. Up to another 8.7 million cases are neither recognised nor treated. There are now over 25 million antidepressant prescriptions made each year in the UK, costing the NHS £80 million.
The announcement comes at the beginning of National Depression Week [18-24 April, 2005] which aims to raise awareness about the realities of depression and reduce the stigma associated with it. Mental health problems, mainly depression, account for about one third of all consultations with doctors.
Professor Glyn Lewis, head of Bristol University’s Academic Unit of Psychiatry, said: “While antidepressants are an effective treatment for depression, there is uncertainty and concern about their use, especially in those with mild depression. These four trials will try to identify people who really need to take them, and what alternative forms of treatment might suit others.”
Professor Debbie Sharp, head of Bristol University’s Academic Unit of Primary Health Care, added: “Depression places a huge burden on society but it is often difficult for the GP to know what form of treatment would be best. These days, not everyone wants to take pills. The results of these trials will help doctors to tailor treatment to the individual.”
The four trials are as follows:
- GENPOD will compare two different types of antidepressants – SSRIs and NaRIs. Most of the current evidence suggests that there is little difference between them in their ability to alleviate depression. Nevertheless, there are clearly patients who respond to one class of compounds, but not the other.
This suggests that the best treatment could be predicted by understanding the genetic reasons why people respond differently. Knowing this would allow GPs and psychiatrists to prescribe the right treatment first time round, thereby speeding recovery.
- RESPOND will look at the benefits of giving SSRI antidepressants to women with postnatal depression – which affects up to 15% of newly delivered mothers – when compared to counselling provided by Health Visitors, which many patients say they prefer.
The infants of postnatal depressed women have been reported to show poorer development, raised rates of emotional and behavioural problems and difficulties in adjustment to school. - IPCRESS will evaluate the effectiveness of an Internet-based psychotherapist, for patients with depression compared with the usual care received while on a waiting list to see a psychotherapist – the average waiting time being eight months.
In addition to the benefits of more immediate access to a psychotherapist, it is considered that writing about thoughts and feelings surrounding distressing experiences can speed up the psychotherapeutic process and improve long-term health and psychological well being. - TREAD will examine whether exercise, in addition to the usual care offered to depressed patients (antidepressants), can improve the outcome of their depression and alter their subsequent use of antidepressant medication.
An important aspect of this trial will be that patients can chose their own form of exercise so that it fits in with their lifestyle. They will be encouraged to take charge of their own activity decisions, rather than be prescribed a particular form of exercise.