Study explores the efficacy of antidepressant drugs for patients with severe depression and medical disorder

This study demonstrates that over 6 weeks of treatment, patients with melancholic depression and medical comorbidity (MC) (specifically cardiovascular or endocrinological MC) had poorer treatment response and a worse functional outcome as opposed to their counterparts without MC. Interestingly, these effects were not related to various antidepressant treatment regimens.

An investigation published in the current issue of Psychotherapy and Psychosomatics by a group of German investigators explored an important clinical question: do patients with severe depression and medical disorder respond to antidepressant drugs?

In particular, this study aimed at the impact of medical comorbidity (MC) on response to antidepressant treatment over 6 weeks in diagnostic subtypes of patients with major depressive episode (MDE). In a clinical sample of 241 admitted patients with MDE, MC was assessed by medical specialists and weekly response to antidepressant treatment was assessed with the Hamilton Depression Scale (HAM-D 21). Over 6 weeks of treatment, patients with melancholic depression and MC had poorer treatment response on the HAM-D scale and a worse functional outcome (GAF) as opposed to their counterparts without MC, which was first detected after 4 weeks of treatment (p = 0.02). More specifically, subjects with melancholic depression and cardiovascular or endocrinological MC showed significantly poorer treatment response over 6 weeks. Interestingly, these effects were not related to various antidepressant treatment regimens. MC has a negative impact on treatment response in patients with melancholic depression.