Concerning the treatment of depression, the figures are of such proportions that details can never be over-looked or neglected. Consider the following. Depressive disorders are amongst the most frequent psychiatric diseases in the Western World, with prevalence numbers between 9% and 18%. According to a 1997 survey (Jindal & Thase, 2003) of the most common reasons for patient visits to family physicians in the United States, depression and anxiety ranked 11th and 17th respectively. The seriousness of this disorder, besides prevalence but in terms of affect, cannot be overstated. Beck (1967) identified five cardinal symptoms of depression: (1) a sad and apathetic mood, (2) feelings of worthlessness and hopelessness, (3) a desire to withdraw from other people, (4) sleeplessness and a loss of appetite and sexual desire, and (5) change in activity level, to either lethargy or agitation. Depression is potentially fatal since most patients think about suicide, about 50% try to commit suicide and up to 15% of patients with sever depression die from suicide (Jindal & Thase, 2003).
The 20th century saw the development of Electroconvulsive therapy in the 1930's, and the development of antidepressant medication the the 1950's as attempts to affect depression directly on a neurobiological level. Today's two prominent forms of treatment are psychopharmaca (with TCA's and SSRI's in the forefront), and psychotherapy (with a form of Cognitive Therapy usually being recommended). The knowledge of the true efficacy of these two dimensions of treatment is of vital importance now, and in the future, where a combination of treatments may be opted for.
The first step in the development of antidepressant medication was taken with the investigation of the ill side effects of the antihypertensive drug Reserpine, in the 1950´s. Though relieving high...