Re: Over-the-Counter Drugs for the Treatment of Mood and Anxiety Disorders – The Views of German Pharmacists. By J. Hamann, K. Linde, H. D. Schweiger, O. Kusmakow, H. Foerstl, Pharmacopsychiatry 2014; 47: 84–88

• References

I have read with great interest the above referenced paper [1]. At a time when psychopharmacological treatment of mood disorders and particularly depression is attacked as rather ineffective [2] [2] [3] [4] in all but the most severely ill patients, OTC drugs may well represent treatment options for a select group of patients.

It was of interest for me to learn that patients preferring OTC drugs, i. e., patients who attempt to treat themselves, were reported by the authors as being younger, with a shorter duration of illness, and with less severe symptoms. And these are just the patients who respond best to a passage of time or placebo intervention, with OTC or homeopathic medications potentially representing an active placebo. Perceiving certain mild pharmacological effects may further enhance the patient’s response. Low severity and short duration of illness were already shown by us in 1966 [5] and 1967 [6] to predict a good placebo response.

Patients remitting, or at least significantly improving, with this approach, may well continue with their OTC treatment for 4–12 weeks. However, patients who either do not improve, or in fact whose symptoms worsen within the first 8–12 weeks of treatment, should contact their family physician for further diagnostic assessment and other treatment considerations.

References modified on 17 February 2015.

Conflict of Interest

Authors declare no conflict of interest.

• References

• 1 Hamann J, Linde K, Schweiger HD et al Over-the-Counter Drugs for the Treatment of Mood and Anxiety Disorders – The Views of German Pharmacists. Pharmacopsychiatry 2014; 47: 84-88
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• 2 Kirsch I, Deacon BJ, Huedo-Medina TB et al Initial Severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLOS Med 2008; 5: 260-268
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• 3 Angell M. The Epidemic of Mental Illness: Why?”. The New York Review of Books 2011; 58: 12
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• 4 Angell M. The Illusions of Psychiatry. The New York Review of Books 2011; 58
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• 5 Rickels K, Downing RW. Drug- and Placebo-Treated Neurotic Outpatients-Pretreatment Levels of Manifest Anxiety. Clinical Improvement, and Side Reactions. Arch Gen Psychiatry 1967; 16: 369-372
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• 6 Rickels K, Lipman R, Raab E. Previous Medication, Duration of Illness And Placebo Response. J Nerv Ment Dis. 1966. 142. 548-554
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Correspondence

• References

• 1 Hamann J, Linde K, Schweiger HD et al Over-the-Counter Drugs for the Treatment of Mood and Anxiety Disorders – The Views of German Pharmacists. Pharmacopsychiatry 2014; 47: 84-88
  Thieme ConnectPubMedSearch in Google Scholar
• 2 Kirsch I, Deacon BJ, Huedo-Medina TB et al Initial Severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLOS Med 2008; 5: 260-268
  PubMedSearch in Google Scholar
• 3 Angell M. The Epidemic of Mental Illness: Why?”. The New York Review of Books 2011; 58: 12
  PubMedSearch in Google Scholar
• 4 Angell M. The Illusions of Psychiatry. The New York Review of Books 2011; 58
  PubMedSearch in Google Scholar
• 5 Rickels K, Downing RW. Drug- and Placebo-Treated Neurotic Outpatients-Pretreatment Levels of Manifest Anxiety. Clinical Improvement, and Side Reactions. Arch Gen Psychiatry 1967; 16: 369-372
  PubMedSearch in Google Scholar
• 6 Rickels K, Lipman R, Raab E. Previous Medication, Duration of Illness And Placebo Response. J Nerv Ment Dis. 1966. 142. 548-554
  Search in Google Scholar