WASHINGTON (AP) -- Starting next week, psychiatrists will be able to prescribe an eagerly awaited new anti-depressant called Lexapro. It's being promoted as more potent and possibly safer than older competitors -- but there's little evidence that it's much better.
Still, Lexapro promises to be a big player in the $12 billion anti-depressant market. So how do patients and doctors choose whether to try it or another of the bewildering array of depression drugs?
"You're playing the odds," is the blunt way Dr. Philip Ninan of Emory University puts it: Each anti-depressant comes with a different set of pros and cons, and there's little way to know in advance which will work best for which patient.
While patients today have better drugs than ever to fight depression, a huge swath of the 19 million Americans afflicted at some point in their lives fail to get relief. Experts estimate up to half of patients who try an anti-depressant stop altogether or switch to another within three months. Some can't handle the side effects; others get little or no benefit -- likely because there are different causes of depression that require novel treatments.
Today's medications emphasize balancing brain levels of the feel-good neurochemical serotonin. Ninan is excited about a different approach, targeting hormones believed to cause patients with depression to have exaggerated responses to stress. But it will take years more research to prove if these experimental "CRF antagonists" fulfill that promise.
With potential breakthroughs so far away, any new option causes excitement -- even if, like Lexapro, the drug isn't very different chemically from its predecessors. Indeed, Lexapro is a fine-tuned version of the popular drug Celexa, the latest in the Prozac-spawned class of "selective serotonin re-uptake inhibitors," or SSRIs.
Lexapro is "not God's answer to this illness, but it is a step forward," Ninan says. "The word I'd use is an incremental advance."
Forest Laboratories Inc., maker of both Celexa and Lexapro, argues that even an incremental advance means Lexapro can make a meaningful difference.
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