The Shocking Truth about Antidepressants

Study finds that patients who are prescribed antidepressants may be “responders” or “non-responders”

Most doctors who put their patients on antidepressants expect a favorable response and hope that the patients will experience noticeable improvements in the symptoms of depression within two weeks. Some doctors even believe that identifying the presence of depression is half the job done and that medicines will take care of the other half. Follow-up is, however, crucial, and one study makes that abundantly clear.
  However, one important study that was published online in 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 patients suffering from clinical depression may be “responders” or “non- responders” on the basis of their response to antidepressants.

This research, it is important to note, does not imply that antidepressants are ineffective. In fact, these medications 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 may even worsen their depression. Therefore, prescribing physicians have to follow up with their patients regularly to see which patients are benefiting from antidepressants and which patients are not.

While “responders” improve, “non-responders” may even seriously be harmed by the side effects of antidepressants

The study in question 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 depressive disorder. A total of 2515 patients were selected to participate in the study. The patients were administered either Cymbalta, or a generic 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 medications 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 along 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 serious side effects of antidepressants without benefiting from their intended purpose. 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 for continuous monitoring of all patients who are taking serotonergic antidepressant medicines for the treatment of their depression. Generally, it is easy to differentiate the responders from the non responders within the first few weeks into the treatment, when the antidepressants' effects normally set in. The treatment with serotonergic medicines must be stopped in non responders, because they may suffer from harmful side effects without any symptom reduction.

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. However, in the meantime, the efficacy of prescribed antidepressant treatment must be followed "manually", as prescribing health care providers discuss how the antidepressants are working with their patients. When an antidepressant is not working, it must be switched out, and it is imperative that these patients also receive psychotherapy to cope with their depression.