Research Report – Gender Differences in Antidepressant Treatment: is psychotherapy an overlooked variable?
September 6th, 2008 |
A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW
A new study examining the effects of the common antidepressent Citalopram (brand name: Celexa) has found clinically significant differences in how the genders respond to its use in treating depression. A study of nearly three-thousand Americans found women 33% more likely to acheive a full remittane of depressive symptoms, despite the fact that their depression was overall more severe than men’s.
What to conclude from this? Researchers believe chemical differences in men’s and women’s biology are responsible, and are focusing on hormones. But there are certainly other possible explanations. It may be that cultural factors make non-pharmacological interventions more necessary for men. It may be that severe depression responds better to pills than moderate depression, and that women – as is well documented, for reasons, biological or environmental, not addressed in this study – are more likely to be more severely depressed. And of course, it may be a fluke – though the numbers in this study are fairly compelling.
Perhaps most important is one confounding variable not addressed by these researchers: Study participants were allowed to continue talk therapy if they were already engaged in that work, and no statistial analysis of that variable was calculated in the findings. Since we know women are more likely than men to seek talk therapy when depressed, this omission is significant. It could be talk therapy – not hormones – that explains women’s superior response to drug treatment. The fact that biology is assumed as the cause, and psychotherapy overlooked, is a telling and diturbing indication of how dominant allopathic thinking has become in the mental health field.
The research was completed at the Unviersity of Michigan this year and showed no differences between men and women in terms of side effects, the amount of time that patients complied with the medication regime, or the time necessary for remission of symptoms. These findings are the largest and most comprehensive study of gender differences in antidepressant treatment ever completed, and are published online in the Journal of Psychiatric Research.
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Therapist Seattle
8 comments so far
Seems there are just too many what ifs and maybes to draw any kind of verifiable conclusion from this research. Maybe women want to get better more than men do- who knows? It could be a lot of different things. I still have my suspicions that in cases of severe depression you will naturally see more improvement than you will in moderate depressive episodes, so maybe this is what is skewing the numbers. I think that everyone versed in this area should keep going along employing the use of talk therapy along with the prescriptions, and hopefully when the perfect balance of that is found then patients will certainly begin to see marked improvements and positive changes in their lives.
There are so many different things that can come into play here. Are there other studies that concur or is this research just one random study?
Maggie, Carla: I’d certainly agree with your assessments; these are just preliminary findings and we can’t draw any broad conclusions from them. Though I stated, “These findings are the largest and most comprehensive study of gender differences in antidepressant treatment ever completed,” I also noted, “there are certainly other possible explanations” for the study’s findings, other than the explanation offered by the researchers.
Here’s some bad news you already know: The research community is biased for the medical model. Research that actually considers holistic approaches is the exception. Sometimes, we who are interested in holistic healing must look at allopathic studies’ data and draw our own conclusions. It’s an imperfect system but as long as pharmaceutical money funds so many psychiatry departments, it’s often the best we can do.
You have a point there. When it is the drug money funding the studies of course the findings may come out a little skewed in their favor. What are the chances of money that is public being made available for these kinds of studies? Slim to none. I think we all know that all too well. Perhaps a new administration which cares more about mental health issues than some in the recent past will make studies like this a little more viable.
What has proven to be the most successful treatment in the past: talk therapy, drugs, or a combo of the two?
Zoe, the overwhelming preponderance of research tells us that a combination of medications and talk therapy is the most effective treatment for depression, in most cases. This study did not change that.
how dang frustrating it is to learn that even in “scientific” studies it is still automatically assumed that female hormones are either the cause of or the blame for something. I am so tired of the whole hormonal argument that I could just burst! There could be so many things going on and I do find it sad that the talk therapy issue was complteely overlooked. It is time that we begin demanding better studies and perhaps not putting as much empasis on studies that are funded soley by big pharmaceutical companies!
I really do not understand why people are surprised when there turns out to be different medical evidence for men and women. We are different and diseases of all sorts manifest themselves in different ways across the genders. Why do we seem surprised that the same is true with mental health issues as well?