I would like to comment on the recent article about antidepressant drugs not working for mild depression.

We in the medical profession are aware that antidepressants work better for anxiety than pure depression. Most depressed patients have a combination of anxiety and depression. People with excess anxiety (General Anxiety Disorder-GAD) are helped by antidepressants. These are people who were raised in a significant dysfunctional family with emotional, physical and/or sexual abuse; others develop general GAD secondary to post-traumatic stress disorder.

Medical research has yet to match a certain type of antidepressant drug to a certain chemical disorder of the basal ganglion of the brain. Eventually this will happen so that we can then match the chemical deficiency to the medication that best treats that deficiency, the same way we match antibiotics to certain organisms. A change in epinephrine, norepinephrine or serotonin levels in the brain may result in increased depression. In the future we will be able to measure these levels in the brain to find the antidepressant drug that best treats this syndrome. Presently, it is a trial-and-error scenario; we may have to use two or three different medications before we find the one that works the best for that patient.

Drugs are not the only treatment for depression. Exercise increases endorphins and helps depression. Thinking positively in every situation increases chemicals in the brain that helps depression according to a well-known psychiatrist, Dr. Burns, at the University of Pennsylvania. Sunlight and perhaps artificial light helps affect these chemicals. Winter months are worse for depression than summer months in the Northeast because of the lack of exposure to sunlight. Often times psychotherapy or cognitive therapy help for depression.

Be careful about stopping antidepressant medications before talking it over with your family doctor.

John P. Pagana, M.D.,

Sunbury