Treating SSRI-resistant depression

Mar 25, 2008

When your antidepressant medication does not work, should you switch to a different medication from the same class or should you try an antidepressant medication that has a different mechanism of action" This is the question asked by researchers in a new report scheduled for publication in Biological Psychiatry on April 1st.

Papakostas and colleagues compared two strategies for treating symptoms of major depressive disorder that do not respond to treatment with a selective serotonin reuptake inhibitor (SSRI) antidepressant: either switching to a second SSRI or to a non-SSRI antidepressant. Some common SSRI antidepressants are fluoxetine (Prozac), citalopram (Celexa) and sertraline (Zoloft), while examples of a few common non-SSRI antidepressants are venlafaxine (Effexor) and buproprion (Wellbutrin, Zyban). The authors combined 4 studies comparing these two types of treatment strategies and performed a meta-analysis on the pooled data.

Dr. George I. Papakostas, corresponding author on this project, explains the results: “Switching from a selective serotonin reuptake inhibitor to a drug with a different mechanism of action was found to be slightly more effective and slightly less-well tolerated than switching to a non-SSRI drug.” Looking at the findings from a clinical perspective, the advantage in effectiveness means that 22 depressed people would need to be switched to treatment with a non-SSRI for one additional person to obtain relief from their symptoms.

John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, adds that this result “may be related to the fact that while somewhat different, the medications evaluated in this report all acted on the monoamine systems of the brain.” Because of the particular design of this study, the authors explain that “subsequent studies examining whether differences in efficacy between these two treatments exist for specific subpopulations, symptoms, or symptom clusters are warranted.” Dr. Krystal concludes that while this advantage could be important, “there continues to be a pressing need to introduce new antidepressant medications that target novel brain mechanisms.”

Source: Elsevier

Explore further: Pentagon: Anthrax shipments broader than first thought

Related Stories

Architects to hatch Ecocapsule as low-energy house

8 hours ago

Where people call home depends on varied factors, from poverty level to personal philosophy to vanity to community pressure. Ecocapsule appears to be the result of special factors, a team of architects applying ...

California farmers agree to drastically cut water use

12 hours ago

California farmers who hold some of the state's strongest water rights avoided the threat of deep mandatory cuts when the state accepted their proposal to voluntarily reduce consumption by 25 percent amid ...

Apple may deliver ways to rev up the iPad, report says

12 hours ago

MacRumors last month said that the latest numbers from market research firm IDC's Worldwide Quarterly Tablet Tracker revealed Apple stayed on as the largest vendor in a declining tablet market. The iPad ...

Recommended for you

Pentagon: Anthrax shipments broader than first thought

11 hours ago

The Pentagon said Friday that the Army's mistaken shipments of live anthrax to research laboratories were more widespread than it initially reported, prompting the Defense Department's second-ranking official ...

Anthrax shipments came from military site in Utah desert

May 29, 2015

The U.S. Army's mistaken shipment of live anthrax samples to government and commercial laboratories occurred at a military post in a desolate stretch of the Utah desert that has been testing chemical weapons ...

User comments : 0

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

Click here to reset your password.
Sign in to get notified via email when new comments are made.