Switching, combining drugs improves treatment outcomes

Drug Store News, April 10, 2006 by James Frederick

WASHINGTON -- Switching or combining drugs can help patients find relief from depression, according to the findings of a recent government-funded study.

Some 50 percent of depression sufferers could feel better through medication, it showed.

The study tracked more than 2,800 depressed adults and found that 1-in-3 recovered while taking the antidepressant Celexa. People who did not recover then went on to try a different medication such as Zoloft, Effexor or Wellbutrin. Of these patients, 21 percent improved. Another group of people, for whom Celexa didn't work, supplemented that drug with Wellbutrin or BuSpar, an anti-anxiety drug, and 30 percent felt better.

The message from this is that if the first try doesn't lead to an optimal outcome, you go to the next step, said Dr. Madhukar Trivedi, professor of psychiatry at the University of Texas Southwestern Medical Center in Dallas.

Despite the higher-than-usual success rate, the antidepressants failed to cure the symptoms in 50 percent of the depressed patients.

This study was the largest of its kind ever conducted. Researchers emphasized that the care provided in the study was greater than patients would usually receive, with intensive monitoring and careful evaluation. The study also included tests that looked more deeply at patients conditions than is regular practice, which allowed problems to arise that might otherwise be missed.

The study did not include a comparison group, which is significant since in most depression studies, 10 percent to 30 percent of people recover when they take placebos.

Depression afflicts some 15 million Americans and costs the United States $83 billion every year. It is believed that the disease leads to the bulk of the country's 30,000 annual suicides.

JAMES FREDERICK

CATEGORY SPECIALIST