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Here is one for you Link linkadge

Posted by ttee on September 11, 2007, at 16:06:03

In reply to Re: News - Antidepressants Vindicated?, posted by linkadge on September 10, 2007, at 19:22:25


Relapse From Antidepressant Medication Likely Due to Loss of Placebo Response


Reuters Health Information 2007. 2007 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

By Megan Rauscher

NEW YORK (Reuters Health) Aug 31 - It cannot be assumed that an antidepressant has lost its effectiveness when a patient relapses while continuing on the medication, because the medication might not have been effective in the first place, according to study findings reported in the Journal of Clinical Psychiatry for August.

"We found that the vast majority of relapses occur in presumptive placebo responders," Dr. Mark Zimmerman, director of outpatient psychiatry at Rhode Island Hospital, told Reuters Health.

Some patients with major depressive disorder, similar to other medical disorders, respond to placebo, Dr. Zimmerman explained. "In clinical practice, where everyone is treated with active medication, you do not know if a patient who responds has gotten better because of the active ingredient of the medication or because of the nonspecific effects of treatment (i.e., the placebo response)."

Similarly, relapses that occur during the continuation phase of treatment could be because of true tachyphylaxis or because the initial response to treatment had been a placebo response.

To investigate, Dr. Zimmerman collaborated with Dr. Tavi Thongy on a meta-analysis of four studies involving 750 patients. These were continuation studies of new generation antidepressants that began as placebo-controlled acute-phase studies.

The researchers report that "two different methods of estimating relapse suggested that the majority of relapses in patients taking antidepressants during continuation treatment could be attributed to relapses occurring in patients who were not true drug responders."

This suggests, Dr. Zimmerman told Reuters Health, "that a message can be conveyed to patients who have repeatedly improved on medication and then lost its benefit that perhaps they are more capable than they think in bringing their own resources to bear to improve their depression."

J Clin Psychiatry 2007;68:1271-1276.


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