Antidepressants fail to treat important, persistent symptoms

Kathleen Blanchard's picture
Antidepressants
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Researchers say antidepressants miss important symptoms of depression. Insomnia, sadness and inability to concentrate that persist in patients taking drugs like SSRI's. The result is increased health care costs and risk for depression associated diseases like obesity, heart disease, diabetes and asthma for approximately 19 million adults in the US diagnosed and treated for depression each year.

Six year study shows incomplete recovery with andidepressants

In a six year study, researchers at UT Southwestern Medical Center tracked depression symptoms in what started with 4000 patients treated in nationwide outpatient clinics. Just 33 percent of patients treated with SSRI's, selective serotonin reuptake inhibitors, experienced remission of symptoms in the first 12 weeks of therapy.

The research study showed patients taking SSRI's that are the most commonly prescribed class of antidepressants continue to experience symptoms of insomnia, decreased concentration and sadness.

Dr. Shawn McClintock, assistant professor of psychiatry and lead author of the analysis explains, "Widely used antidepressant medications, while working overall, missed these symptoms. If patients have persistent residual symptoms, these individuals have a high probability of incomplete recovery."

Seventy five percent of participants who were from the Sequenced Treatment Alternatives to Relieve Depression, or STAR*D study, reported five or more ongoing symptoms despite using antidepressants and all had 3 to 13 symptoms that persisted.

The team looked at appetite and weight loss, sleep, outlook, energy, fatigue and suicide thoughts at the beginning and end f the study.

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Seventy percent reported trouble making decisions, 71 percent experience sadness and almost 79 percent said they had middle of the night insomnia.

Included in the data was whether patient symptoms started before or during treatment. One of the fears about taking antidepressants is increased risk for suicide. According to McClintock, the study found no evidence of persistent or new thoughts of suicide associated with antidepressant medications.

More focus needed on residual depression symptoms

The research team also analyzed data from 2,876 STAR*D phase 1 study participants, finding just 15 percent (428 patients) experienced a 50 percent continued relief from depression symptoms at 12 weeks with SSRI treatment.

The researchers suggest more research to understand the link between depression and inability to concentrate and more focus on treatments for residual depression symptoms identified in the study.

Dr. Madhukar Trivedi, professor of psychiatry at UT Southwestern, author and co-principal investigator of STAR*D who analyzed the data said, "Our findings do suggest that the use of measurement-based care techniques to identify and target residual depressive symptoms is essential to help patients return to normal function and recover from depression in the long term."

The study shows the need for targeted depression treatment that is missed by medication therapy and found in the largest depression research study to date. The cost of treating depression and related diseases in the United States is an estimated an $83 billion annually. The new study, that is considered a "benchmark" in depression research show antidepressants work overall, but fail to treat important and persistent symptoms.

UT Southwestern Medical Center

Image credit: Morguefile.com

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