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: The argument in favor of doping

add to favorites email to friend print save as pdf

Related Stories

China demand to fuel Hong Kong iPhone grey market

15 hours ago

Wealthy mainland Chinese looking to buy the new iPhone 6 next week could expect to pay an eye-watering US$2,500 for the handsets in Hong Kong, following Apple's decision to delay the launch in China.

Netflix sets sights on European screens

15 hours ago

US online streaming giant Netflix will launch the second phase of its European expansion plan on Monday as it sets about seducing French viewers with a "House of Cards"-style drama set in Marseille.

MIT ATLAS robot demo shows advanced moves (w/ Video)

Sep 07, 2014

The bipedal robot ATLAS from MIT is moving on. Reacting to the recent video of "MIT Atlas truckin' with a truss," TechCrunch said, "We've seen the cute little guy walk, toddle, and climb over obstacles but ...

Recommended for you

The argument in favor of doping

10 minutes ago

Ahead of Friday's court ruling on whether ASADA's investigation into the Essendon Football Club was lawful, world leader in practical and medical ethics Professor Julian Savulescu, looks at whether there is a role for performance-enhancing ...

Errata frequently seen in medical literature

22 hours ago

(HealthDay)—Errata, including those that may materially change the interpretation of data, are frequent in medical publications, according to a study published in the August issue of The American Journal of ...

User comments : 0