If one antidepressant doesn’t work, try another

Not everyone with depression will respond to a particular Antidepressant medication, but there’s a good chance that a second or third choice will be effective, researchers have found.

Dr. Frederic M. Quitkin and colleagues from Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, examined remission rates when patients who did not get better on one drug were switched to another, and then to a third if necessary.

The study, published in the Journal of Clinical Psychiatry, involved 171 patients treated with second-generation antidepressants and 420 patients treated with first-generation antidepressants.

Among the group treated with a second-generation antidepressant, 93 percent of those who stayed in the trial eventually achieved remission of their depression.

Among patients treated with a first-generation antidepressant, the remission rate was 96 percent.

“Our data suggest that correctly diagnosed depressed patients who receive 3 adequate trials of Antidepressant medications have an approximately 90 percent chance of achieving a state of remission,” the authors conclude.

However, the team notes that altogether 111 participants dropped out of the studies.

“We could find no systematic analysis of why patients leave treatment,” the investigators say. “A major challenge is motivating depressed patients to continue treatment.”

SOURCE: Journal of Clinical Psychiatry, June 2005.

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