JOSEPH FRIEDMAN, MD: 1987 was really a turning point for the treatment of depression, because that year was the introduction of fluoxetine, which is one of the first members of a class of medications called the selective serotonin reuptake inhibitors. And these drugs differ as a whole class from the older drugs because they have much less side effects.
ANNOUNCER: Older antidepressants, known as tricyclics, can be dangerous if mixed with other drugs. But Prozac and newer medications are associated with their own problems, such as a lower sex drive and weight gain.
JOSEPH FRIEDMAN, MD: The way physicians tailor a treatment is by considering what types of side effects one patient might be more sensitive to than another. And this way you could choose which drug might be appropriate.
ANNOUNCER: Because antidepressants can sometimes take a few weeks to take effect, people with severe depression may need to combine them with sedative drugs at first.
JOSEPH FRIEDMAN, MD: A combination of antidepressants with anti-anxiety drugs, at least perhaps in the beginning of the treatment, would be most helpful, because it could restore somebody's sleep patterns back to normal and can alleviate the anxiety, the internal distress that they feel as a result of the depression.
ANNOUNCER: If such medications and talk therapy fail to work, there is another option known as electroconvulsive therapy.
JOSEPH FRIEDMAN, MD: Electroconvulsive therapy is probably one of the longest-standing, oldest treatments for depression that we have.
ANNOUNCER: This therapy is highly effective, but it involves general anesthesia and attaching electrodes to the head to essentially shock the brain into feeling better.
JOSEPH FRIEDMAN, MD: Now, we don't know why this treatment works, but it works. It is effective. But it is a last resort.
ANNOUNCER: What is important to remember is that people with severe depression now have many treatments that can help.