Dual medications for depression increases costs, side effects with no benefit to patients

May 2, 2011

Taking two medications for depression does not hasten recovery from the condition that affects 19 million Americans each year, researchers at UT Southwestern Medical Center have found in a national study.

"Clinicians should not rush to prescribe combinations of antidepressant medications as first-line treatment for patients with ," said Dr. Madhukar H. Trivedi, professor of psychiatry and chief of the division of at UT Southwestern and principal investigator of the study, which is available online today and is scheduled for publication in an upcoming issue of the .

"The clinical implications are very clear – the extra cost and burden of two medications is not worthwhile as a first treatment step," he said.

In the Combining Medication to Enhance Depression Outcomes, or CO-MED, study, researchers at 15 sites across the country studied 665 patients ages 18 to 75 with major depressive disorder. Three treatment groups were formed and prescribed antidepressant medications already approved by the Food and Drug Administration. One group received escitalopram (a selective serotonin reuptake inhibitor, or SSRI) and a placebo; the second group received the same SSRI paired with bupropion (a non-tricyclic antidepressant); and a third group took different : venlafaxine (a tetracyclic antidepressant) and mirtazapine (a serotonin norepinephrine reuptake inhibitor). The study was conducted from March 2008 through February 2009.

After 12 weeks of treatment, remission and response rates were similar across the three groups: 39 percent, 39 percent and 38 percent, respectively, for remission, and about 52 percent in all three groups for response. After seven months of treatment, remission and response rates across the three groups remained similar, but side effects were more frequent in the third group.

Only about 33 percent of depressed patients go into remission in the first 12 weeks of treatment with antidepressant medication, as Dr. Trivedi and colleagues previously reported from the Sequenced Treatment Alternatives to Relieve Depression, or STAR*D, study. STAR*D was the largest study ever undertaken on the treatment of major depressive disorder and is considered a benchmark in the field of depression research. That six-year, $33 million study initially included more than 4,000 patients from sites across the country. Dr. Trivedi was a co-principal investigator of STAR*D.

The next step, Dr. Trivedi said, is to study biological markers of depression to see if researchers can predict response to antidepressant medication and, thus, improve overall outcomes.

Explore further: Antidepressants may not improve all symptoms of depression, researchers find

Related Stories

Antidepressants may not improve all symptoms of depression, researchers find

April 21, 2011
Even people who show a clear treatment response with antidepressant medications continue to experience symptoms like insomnia, sadness and decreased concentration, researchers at UT Southwestern Medical Center have found ...

Recommended for you

Study provides hope that schizophrenia isn't as deep-rooted in affected individuals as previously believed

December 8, 2017
A schizophrenia patient's own perceptions of their experiences—and confidence in their judgments—may be factors that can help them overcome challenges to get the life they wish, suggests a new paper published in Clinical ...

The evolutionary advantage of the teenage brain

December 7, 2017
The mood swings, the fiery emotions, the delusions of immortality, all the things that make a teenager a teenager might just seem like a phase we all have to put up with. However, research increasingly shows that the behaviors ...

Study reveals gap in life expectancy for people with mental illness

December 7, 2017
New research from The Australian National University (ANU) has found that men who are diagnosed with a mental health condition in their lifetime can expect to live 10.2 years less than those who aren't, and women 7.3 years.

Reading on electronic devices may interfere with science reading comprehension

December 6, 2017
People who often read on electronic devices may have a difficult time understanding scientific concepts, according to a team of researchers. They suggest that this finding, among others in the study, could also offer insights ...

Study suggests giving kids too many toys stifles their creativity

December 6, 2017
(Medical Xpress)—A team of researchers at the University of Toledo in the U.S. has found that children are more creative when they have fewer toys to play with at one time. In their paper published in the journal Infant ...

Psychosis incidence highly variable internationally

December 6, 2017
Rates of psychosis can be close to eight times higher in some regions compared to others, finds a new study led by researchers at UCL, King's College London and the University of Cambridge.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.