Next step in depression treatment? Add rather than switch

Next step in depression treatment? Add rather than switch
Credit: Yale University

Millions of patients suffering from major depression get little relief from the first drug they are prescribed. A major new study of 1,522 patients at 35 U.S. Veterans Health Administration medical centers shows these patients benefit more from adding an antidepressant treatment than from switching to another one, researchers report July 11 in the journal JAMA.

"We found that among three strategies evaluated in this study evidence of the greatest symptom benefit was provided by adding an antipsychotic to previous antidepressant therapy," said lead author Dr. Somaia Mohamed, associate clinical professor of psychiatry at Yale University School of Medicine and of the VA Connecticut Healthcare System, West Haven, Connecticut.

Less than a third of 16 million Americans with obtain relief of symptoms from the first drug prescribed. The new study of this population showed a remission rate of 28.9% of those who augmented initial with the antipsychotic aripiprazole (Abilify) after 12 weeks. This was a significantly greater proportion than the 22% remission among who discontinued use of one antidepressant and switched to another (buproprion).

The group taking aripiprazole was also significantly more likely to show a clinically meaningful response to treatment than either switching to another antidepressant or adding another antidepressant to the original medication, the authors report.

"The study by Mohamed and colleagues is one of the very few definitive studies addressing this question and it suggests that that all options are not alike," said Dr. John Krystal, the McNeil Professor and chair of the Yale Department of Psychiatry. "This study provides the type of detailed guidance that doctors need."

Explore further

Study compares switching meds vs. an additional med for patients unresponsive to an antidepressant

Provided by Yale University
Citation: Next step in depression treatment? Add rather than switch (2017, July 12) retrieved 13 October 2019 from
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Feedback to editors

User comments

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