Antidepressants may heighten depression

NEW YORK - Reuters

According to a new study, about four in five patients on all antidepressants were responders’. Hürriyet photo

According to a new look at past antidepressant trials, up to a fifth of patients on Cymbalta and similar medications may actually do worse than those given drug-free placebo pills.

Researchers found that patients’ symptoms over the first couple months of antidepressant use separated them into “responders,” who got progressively better, and “non-responders,” who didn’t improve with treatment but may still have suffered side effects.

However, “It’s difficult to say a priori who will be in which group,” Ralitza Gueorguieva, the study’s lead author from the Yale University School of Medicine in New Haven, told Reuters Health.

The findings highlight the importance of identifying as soon as possible which patients will and won’t respond to certain drugs, her team said.

The researchers combined data from seven studies that randomly assigned patients to receive Eli Lilly’s drug Cymbalta (known generically as duloxetine), other antidepressants, or a placebo pill for two months. Those trials involved a total of about 2,500 people with major depression.

People getting the placebo tended to report small, gradual improvements in depression symptoms. On the other hand, those on Cymbalta or another antidepressant fell into one of two categories: most had steeper, steady improvements in depression symptoms, but a sizeable chunk didn’t seem to get any better.

About four in five patients on all antidepressants were responders. For Cymbalta in particular, about 84 percent of patients improved and 16 percent did not.

Medication responders saw significantly bigger improvements in their depression symptoms than patients assigned to the placebo. Non-responders, however, did worse.

Differences between antidepressant responders and non-responders were seen as early as a week or two into treatment, and the researchers wrote in their Archives of General Psychiatry report that initial improvements seem to predict who will have a better outcome on Cymbalta, along with the other drugs.