Long-term antidepressant medication use may not help patients over the long haul, study says

After a period of time, antidepressant use in individuals with depression was not associated with better health-related quality of life, (HRQoL), compared to those with depression who did not take medications, a new study published in the open-access journal PLOS ONE suggested. 

“It is generally well known that depression disorder has a significant impact on the health-related quality of life (HRQoL) of patients. While studies have shown the efficacy of antidepressant medications for treatment of depression disorder, these medications’ effect on patients’ overall well-being and HRQoL remains controversial,” study author Omar Almohammed, PhD, who is an Assistant professor of clinical pharmacy at  King Saud University, in Saudi Arabia, and his colleagues said in a news release about their research study.

The researchers analyzed data from the 2005-2015 United States’ Medical Expenditures Panel Survey (MEPS), a type of longitudinal study that tracks the health services Americans use. During the time of the study, the authors found that 17.47 million adult patients were diagnosed with depression each year with two years of follow-up and 57.6% of those were treated with antidepressant medications. 

The investigators looked at the results of the mental component of the SF-12, a survey that tracks health-related quality of life. The release stated that they noted a positive change with the use of antidepressants however, the change in quality of life reported among those on the medication for over two years, was not significantly different from that reported among those not treated with antidepressants.

The researchers said in the published report that the primary purpose of using antidepressant medications or psychotherapy is to improve outcomes including the patient’s health-related quality of life and said in the release, “Although we still need our patients with depression to continue using their antidepressant medications, long-term studies evaluating the actual impact for pharmacological and non-pharmacological interventions on these patients’ quality of life is needed. With that being said, the role of cognitive and behavioral interventions on the long term-management of depression needs to be further evaluated in an effort to improve the ultimate goal of care for these patients; improving their overall quality of life.”

Dr. Lynn Bufka, PhD, ABPP, is a board certified licensed psychologist and Associate Chief, Practice Transformation at the American Psychological Association. Bufka was not involved with the study, but told Fox News in an interview that this report raises awareness that health professionals should be looking at quality of life as a patient outcome. She said more studies are needed regarding this issue.

Early adulthood depression was associated with cognitive impairment and faster cognitive decline, according to a study building on a body of dementia research. 
(iStock)

Bufka also told Fox News that in treatment for depression, there are typically two goals that a professional is interested in: the symptoms and the problems that prompted the individual to seek the treatment. She further explained that there is an acute phase of depression where medication may be useful and then a maintenance phase where the medication dosage may need to be adjusted and combined with other interventions such as psychotherapy, exercise, and diet to help improve an individual’s quality of life. 

The psychologist told Fox News, “There are many people for whom medication is great and for others that medication can provide enough of a dent in depression that they can engage in psychotherapy.” 

Bufka also told Fox News, “People should be comfortable that medications can be beneficial but they don’t answer everything. You will get some changes, but medications alone won’t give you an amazing quality of life – it just gives us a glimpse.” Bufka explained that medication can be a tool, but is not a perfect tool and she stressed the importance of the patient discussing with their therapist their desired outcome when it comes to their treatment. 

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Bufka also added that medication and psychotherapy have different effects on the body and it is vital to know which is more important to use at that particular moment. “Psychotherapy’s goal is to give the tools to address the challenges moving forward where medication helps to alter the biochemistry which can give you a different perspective and different approach,” the psychologist explained. 

Bufka also noted that studies show that a significant portion of prescribers of antidepressants are the patient’s primary care physician and not a psychiatrist, who specializes in medications and appropriate dosing in different stages of psychiatric conditions, including depression. She said this quite possibly could play a role in the study’s findings. 

In this photo illustration a lonesome woman is sitting in her living room.
(Ute Grabowsky/Getty Images)

Dr. Scott Krakower, DO, DFAACAP, is an attending Psychiatrist at Northwell Health Zucker Hillside Hospital and told Fox News, “It is hard to interpret the findings of this study and this should be interpreted with caution. Antidepressants do help with the treatment of depression.  This has been demonstrated with a plethora of studies.  While there has been concern with a large placebo effect of these agents, there does appear to be improvement to some extent with mood and other measurable outcomes.”

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The psychiatrist explained that in severe cases of depression, medication may be warranted along with other interventions but in cases of mild depression, individual therapy may be tried alone to mitigate potential side effects of medicines. Krakower also told Fox News, “It has also been reported that medication may help to alleviate the amount of time being spent in therapy, to allow patients to live more productive lives. Therefore, medication may also be considered an option.” 

Krakower also said the best treatment for depression remains with medication and individual therapy. 

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The study authors did note in the release that they were not able to separately analyze any subtypes or varying severities of depression and did say that future studies should investigate the use of non-pharmacological depression interventions used in combination with antidepressants.