Antidepressants Not a Cure-All for Depression

Common antidepressants not effective with all symptoms of depression

(RxWiki News) You're taking an antidepressant and feeling better overall but still have bouts of sadness. Or, maybe you're still having trouble with insomnia or finding it hard to concentrate. You're not alone - not by a long shot.

After analyzing data from the largest study on treating depression, researchers at the University of Texas Southwestern Medical Center found lingering symptoms to be common.

"People taking antidepressants rarely have thoughts of suicide."

Researchers tracked a wide range of symptoms of depression, including: sadness, suicidal thoughts, and changes in sleep patterns, appetite/weight, concentration, outlook and energy/fatigue – at the start of the trial and at the end of the antidepressant treatment course.

All of the study participants reported suffering from between three and 13 symptoms, and 75 percent of the responders reported five or more residual symptoms.

“Widely used antidepressant medications, while working overall, missed these symptoms. If patients have persistent residual symptoms, these individuals have a high probability of incomplete recovery,” said Dr. Shawn McClintock, assistant professor of psychiatry and lead author of the analysis available in the April print issue of the Journal of Clinical Psychopharmacology.

One positive finding was that thoughts of suicide rarely persisted or emerged during treatment, researchers found.

“Some people fear that antidepressant medication increases thoughts of suicide,” Dr. McClintock said. “This provided counterevidence of that.”

The most common symptoms that participants reported were insomnia (nearly 79 percent), sadness (nearly 71 percent) and decreased concentration and decision-making skills (nearly 70 percent).

In Depth

  • This study looked at data from the Sequenced Treatment Alternatives to Relieve Depression, or STAR*D study, the largest ever on the treatment of major depressive disorder and considered a benchmark in the field of depression research.
  • The six-year, National Institute of Mental Health-sponsored study initially included more than 4,000 patients with major depressive disorder from clinics across the country.
  • Researchers in the STAR*D trial found that only 33 percent of people go into remission in the first 12 weeks of treatment with an antidepressant medication known as an SSRI, or selective serotonin reuptake inhibitor, the most commonly prescribed medication for the treatment of depression.
  • Individuals on SSRIs often still exhibit symptoms of depression.
  • Dr. McClintock and colleagues looked at data from the 2,876 STAR*D participants who completed the first phase of the trial – treatment with an SSRI for 12 weeks. About 15 percent of those participants, or 428 people, responded to treatment with no remission.
  • Response was defined as a 50 percent decrease in severity of depression.
  • The average age of participants was 40, 73 percent were white, and 66 percent were female.
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Review Date: 
April 21, 2011