Med Switch Not Always Best Choice With Tough Depression

Adding an antipsychotic or a second antidepressant may produce better results, researchers say

By Robert Preidt

Tuesday, July 11, 2017

TUESDAY, July 11, 2017 (HealthDay News) -- Switching to another antidepressant may not be the best way to help depression patients who don't respond to the first antidepressant they take, a new study indicates.

Among more than 1,500 depression patients at 35 U.S. Veterans Health Administration medical centers, better symptom relief was achieved when people were prescribed an antipsychotic medication or a second antidepressant rather than being switched to another antidepressant, the researchers found.

"We found that among three strategies evaluated in this study, evidence of the greatest symptom benefit was provided by adding an antipsychotic to previous antidepressant therapy," said study author Dr. Somaia Mohamed. She is an associate clinical professor of psychiatry at Yale University School of Medicine.

The researchers found that 29 percent of patients who took the antipsychotic drug aripiprazole (Abilify) for 12 weeks, along with their original antidepressant, achieved nearly total remission of their depression symptoms.

The rate was 27 percent among patients who had the antidepressant bupropion added to their original antidepressant, and 22 percent among those who switched from their original antidepressant to another one, the findings showed.

Patients who took aripiprazole with their original antidepressant were also much more likely to have a clinically meaningful response to treatment (symptoms cut in half) than those who took bupropion with their original antidepressant or switched to another antidepressant.

Less than one-third of the 16 million Americans with major depression benefit from the first antidepressant they're prescribed, the study authors noted in a Yale news release.

The study was published July 11 in the Journal of the American Medical Association.

According to Dr. John Krystal, chair of Yale's department of psychiatry, "The study by Mohamed and colleagues is one of the very few definitive studies addressing this question. This study provides the type of detailed guidance that doctors need."

SOURCE: Yale University, news release, July 11, 2017

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