Have you ever been to a psychiatrist and received a diagnosis of anxiety, depression, bipolar disorder, etc.? Since this is a psychiatric/psychological website I'm going to assume the answer, for the most part, is yes.

Let's say that you've received a diagnosis of major depression. The next step is the psychiatrist chooses a medication that he (or she) believes will help you. As you know, there is more than one medication that helps alleviate depression, so how does the psychiatrist pick one medication out of a dozen (or more)? The better question is how doesn't the psychiatrist choose a medication?

Choosing a medication is almost always comparing NNT to side effects. I bet 99% of people reading this post have no idea what NNT means. And it's EXTREMELY important! NNT means the average Number of people (with the same diagnosis that you have) Needed to Treat (NNT) before 1 (one) person benefits from the medication more than the placebo effect. Thus the NNT is never a number such as 1 (one). Furthermore, every medication has an NNT (and every psychiatrist knows the NNT of every medication).

Most of you are probably familiar, unlike the NNT, with side effects. These effects range from life-threatening to very mild. Just like the NNT, every psychiatrist knows the side effects of every medication.

Here's my take-home point: Instead of running the risk of trying medication after medication after medication, all you have to do is compare the NNT to the percentage, and severity, of side effects.

I hope this helps.

[Nammu]

how about adding in commonalities? Like gender and race, that affects side effects too. The dosage should also be weighed to size...not just starting dose of X. To have a 300lb man and a 100lb woman on the same drug is going to have different side effects and needs to be part of the equation.

Every Pdoc should know the side effects of every med but most don't they know the ones they most often use and are bias strongly in favor of those they use most. So two pdocs all other things being equal may prescribe different meds for the same person based on their preferred drug of choice.

To me its still a game of chance until drugs are studied by an outside scientific group not related to drug companies and docs are taught that not all classes of drugs are equal for all people.

I work in healthcare. NNTs are so useful. Here's the website we use in the UK theNNT. I would also recommend pharmacogenomic testing. How drugs are prescribed will change hugely over the next 5-10 years.

Here's treatment of acute bipolar depression using NNT and NNH. 7 medications are in the trial, and two (Seroquel and Latuda) perform best:

http://www.healthline.com/health-blo...t-using-nntnnh

[cloudyn808]

The psychiatrists coming out of med school are using DNA whenever possible. In the US Medicare pays for the testing and some private insurers cover the cost if 2 or more drugs have been tried. It's an amazing science and can literally take years off the trial and error process. If I was newly diagnosed with depression, I would gladly pay the $600-$900 to find the best treatments as quickly as possible.