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Not all patients put on antidepressants show expected results. In fact, some may show further deterioration of their symptoms. Shocking but true, as a new study has found out. A constant monitoring of benefits is required for patients on antidepressants.

Study finds that Patients may be “Responders” or “Non- responders” on the Basis of Their Response to Antidepressants

Most of the doctors who put their patients on antidepressants expect a favorable response and hope that the patients will soon get rid of the symptoms of depression. It is believed that identifying the disease is half the job done and that the medicines will take care of the other half.
However, a recent study, published online in the December issue of the journal Archives of General Psychiatry, has proved that this belief may be only partially true when you are dealing with patients of depression. The study found that the patients may be “responders” or “non- responders” on the basis of their response to antidepressants.

It does not imply that antidepressants are ineffective. In fact, they have been found to be effective in the majority of patients. However, in a certain percentage of patients, they are not able to produce the desired results. Further, the study showed that these patients are actually better off without these medicines. Prescribing antidepressants to this group of patients worsens their depression. Therefore, the physicians have to follow up the patients regularly to see which patients are benefiting from antidepressants and which patients are not.

While “Responders” improve, “Non responders” may even suffer from Side Effects of Antidepressants

The present study was led by Dr. Ralitza Gueorguieva from the Yale University School of Health. She, along with her colleagues, studied the effect of duloxetine, better known as Cymbalta, and a selective serotonin reuptake inhibitor (SSRI) on patients suffering from major depression. A total of 2515 patients were selected for the study. The patients were administered either Cymbalta, or SSRI or a placebo for a period of two months. Their treatment trajectory was closely assessed.

It was seen that the course followed by patients on Cymbalta or SSRI was similar. Compared to patients who received a placebo, these patients showed favorable results. Four out of five patients receiving these medicines showed a steep improvement in their depression symptoms. However, a few of these patients did not respond to the treatment on the expected lines. In fact, their response to medicines was worse than that of patients on placebo. It was seen that while “responders” improve, “non responders” may even suffer from side effects of antidepressants. The non responders exhibited symptoms like lack of sleep and various gastrointestinal symptoms.


On the basis of the results of the study, the researchers have stressed the need of continuous monitoring of the patients on serotonergic antidepressant medicines for the treatment of their depression. Normally, it is easy to differentiate the responders from the non responders within the first few weeks into the treatment. The treatment with serotonergic medicines must be stopped in non responders, lest they suffer from side effects.

There is a need for further studies to identify the biomarkers or other ways of predicting the response of the patient to these antidepressants. It could be certain genetic biomarkers or specific type of symptoms, which could differentiate between the responders and non responders. Treatment of depression could then be initiated on the basis of the responder status of the patient.

  • “Some depressed people do worse on drugs: study”, by Genevra Pittman, Reuters Health, published on December 12, 2011, accessed on December 17, 2011. Retrieved from: http://uk.reuters.com/article/2011/12/12/us-antidepressants-idUKTRE7BB0MT20111212
  • “Trajectories of Depression Severity in Clinical Trials of Duloxetine- Insights Into Antidepressant and Placebo Responses”, by Ralitza Gueorguieva, et al, Archives of General Psychiatry, published in December, 2011, accessed on December 17, 2011. Retrieved from: archpsyc.ama-assn.org/cgi/content/abstract/68/12/1227
  • Photo courtesy of bizzzarro on Flickr: www.flickr.com/photos/bizzzarro/441904256