Two Meds Don't Help Beat the Blues

Multiple depression medications only raise costs and side effects

(RxWiki News) New studies show that most people taking antidepressants still suffer some symptoms of depression. Additional medications are often prescribed in the hopes of totally banishing the blues. But those efforts don't work.

Taking two medications for depression does not speed recovery from the condition that affects 19 million Americans each year, researchers at UT Southwestern Medical Center have found in a national study.

“Clinicians should not rush to prescribe combinations of antidepressant medications as first-line treatment for patients with major depressive disorder,” said Dr. Madhukar H. Trivedi, professor of psychiatry and chief of the division of mood disorders at UT Southwestern and principal investigator of the study. He adds that this practice only adds to the cost of care and exposes patients to additional side effects.

"Taking two medication pills for depression doesn't help."

Researchers studied three groups of patients taking different combinations of medications. One group took an antidepressant and a placebo (sugar pill). After 12 weeks of treatment, the overall results were the same for all three groups.

Only about 33 percent of patients experience full relief (remission) after the first 12 weeks of treatment with antidepressant medication. That was shown in the largest study of its kind, the Sequenced Treatment Alternatives to Relieve Depression, or STAR*D.

The next step, Trivedi said, is to study biological markers of depression to see if researchers can predict response to antidepressant medication and therefore improve overall outcomes.

The Study

  • Researchers at 15 sites across the country studied 665 patients ages 18 to 75 with major depressive disorder
  • Three treatment groups were formed: One group received escitalopram (a selective serotonin reuptake inhibitor, or SSRI) and a placebo (sugar pill); second group received the same SSRI and bupropion (a non-tricyclic antidepressant); third group took different antidepressants: venlafaxine (a tetracyclic antidepressant) and mirtazapine (a serotonin norepinephrine reuptake inhibitor)
  • Study was conducted from March 2008 through February 2009
  • Results show that after 12 weeks of treatment, remission and response rates were similar across the three groups: 39 percent, 39 percent and 38 percent, respectively, for remission
  • About 52 percent in all three groups showed response, or improvement of symptoms
  • After seven months of treatment, remission and response rates across the three groups were similar, but side effects were more frequent in the third group
Reviewed by: 
Review Date: 
May 2, 2011