Depression is a complex issue for those with CFS. What appears to be depression could part of a negative physical response to overexertion – characteristic of CFS – that can be overwhelming, both physically and mentally. But in some cases, particularly when faced with years of limiting pain, isolation, misunderstanding and misdiagnosis, or for chemical reasons (whether related or unrelated to CFS), treating depression can become necessary and desirable. A report announces there are now more effective antidepressants to help. This new wave of antidepressant medications is capable of controlling depression, while minimizing the side effects.
Up until the 1980s, there were really only a few options for treating depression. But these carried some fairly serious side effects, not to mention not reflecting the variety of reasons people experience depression. In the last decade, drugs such as Prozac were developed that provided safer relief. But users could not escape such possible side effects as gaining weight or experiencing sexual dysfunctions when taking the selective serotonin reuptake inhibitors (SSRIs) drugs.
Some of these fairly new antidepressants include venlafaxine (Effexor), nefazodone (Serzone), mirtazapine (Remeron) and reboxetine (Vestra — not yet available in the US). They are about as effective as SSRIs – and certainly more effective then the drugs available before SSRIs. Besides functioning differently from SSRIs, another difference in this new generation of drugs lies in their side effects. For example, one drug, mirtazapine, increases the appetitie, making a possible choice for people who lose weight while depressed. Since research has shown that nefazodone relieves insomnia, it might be appropriate for people with depression who are having a difficult time sleeping – a particular benefit to those with CFS. In addition, one type of drug increases energy, while another features a sedating effect. The upshot is, people who couldn’t take SSRIs, due to the side effects, have a broader set of treatment options in this new generation of drugs.
The biggest advantage to the different functionality of these newer drugs is that they can be adapted to the individual. With this in mind, it is encouraging to realize CFS patients and their doctors have some more choices as to how to cope with depression.
The Lancet 2000; 355:911-918.