Despite public and professional misgivings, antidepressants and electroconvulsive therapy (ECT) are the most effective treatments for moderate to severe depression, state Professor Klaus P Ebmeier and colleagues in a Seminar which reviews recent developments and current controversies in depression.
In this review of the last 5 years' developments in research into depression published in The Lancet, the authors Klaus P Ebmeier, Claire Donaghey of the Division of Psychiatry, University of Edinburgh and J Douglas Steele of the Department of Mental Health, University of Aberdeen focus on recent advances and current controversies.
They cover epidemiology and basic science as well as the treatment of depression in adults in all its forms. Depression in childhood and adolescence, as well as in old age has been covered in recent Seminars in The Lancet.
Depression in adulthood remains a very common and under-treated condition, resulting in a high degree of disability. Increasingly detailed knowledge about impairment of information processing in depression is being supplemented by quantitative studies of the brain processes underlying these impairments. Most patients improve with present treatments. The mechanisms of action of antidepressants are not fully understood; the hypothesis that reversing hippocampal cell loss in depression may be their active principle is a fascinating new development.
Moral panic about the claim that antidepressant serotonin reuptake inhibitors cause patients to commit suicide and become addicted to their medication may have disconcerted the public and members of the medical profession. The authors describe the considerable effort that has gone into collecting evidence to enlighten this debate.
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