Follow-Up on Antidepressant Use over Eight Years

Summary
Many studies have been conducted to examine the short-term effects of antidepressants in sufferers of major depression. However, few studies have analyzed the long-term effects of these drugs. The current study investigated the long-term effects of use of antidepressants in patients with depression. Results showed that those who were using antidepressants at the beginning of the study were less likely to use antidepressants at the end of the study, which spanned the years between 1998/99 and 2006/07.

Introduction
Depression is a common mental condition that affects millions of individuals. It has been seen that the use of drugs to curb depression has been on the rise in the last decade. It has also been found that many individuals with this ailment fail to take medications for their condition. Over the last three decades, there have been several clinical trials that assess the effectiveness of antidepressant medications. However, many of these trials check for the effectiveness of these drugs only for six weeks at the most. Also, most of these trials tend to select patients who have no other complications and ailments apart from major depression. There is no evidence of the effectiveness of these medications in large populations of patients suffering from depression for durations spanning several years. The current study attempted to look at the long-term effects of antidepressant drugs and depression status eight years later on individuals with major depression in a longitudinal cohort of adult Canadians.

Methodology
* This study included 486 patients who had suffered from depression in 1998 and 1999 and 321 of these patients were followed-up on in 2006 and 2007.
* At end of the study period of eight years, the status of their depression and use of antidepressants was assessed.
* The factors that were taken into account in this study included severity of symptoms of depression, earlier episodes of depressive bouts between 1994 and 1997, general health status, social support systems and other factors such as socioeconomic status, age, gender etc.

Data/Results/Key Findings
* Results showed that 29 percent of individuals with major depression in this study were taking antidepressants at baseline.
* The results also revealed that those who took antidepressants at the beginning of the study in 1998 and 1999 were less likely to be using the antidepressants in 2006 and 2007.
* It was also seen that those who had more severe symptoms of depression and took antidepressants at the beginning of the study had a more improved status and required lesser use of the antidepressants at the end of the study period.

Next steps/Shortcomings
Authors agree that this study included only a small group of people; larger studies can reinforce the findings of this study. The authors also confirm that there are many other factors that affect the treatment and outcome of individuals with depression and many of these have not been assessed in this study. The notable outcome according to the authors was the co-existence of other psychiatric illnesses such as anxiety disorders. This could have skewed the results of this study according to the researchers. This study also failed to look at the side effects associated with the use of antidepressants taken for a long duration.

Conclusion
This study included adult sufferers of depression from different age groups and was one of the first studies that analyzed the effectiveness of antidepressants used for nearly a decade by these adults. The authors conclude that initial treatment of depression with antidepressants lead to a better outcome and may even decrease the use of antidepressants 8 years after the initial recruitment of the patients in the study. The authors confirm that this study has numerous shortcomings, notable of which is the small sample of patients and non-inclusion of several criteria that could have affected the outcome of patients with depression at the end of the study. However, they add that this study does suggest that those who take early treatment for depression may derive long-term benefit from it.

For More Information:
The Association between Antidepressant Use and Depression Eight Years Later: A National Cohort Study
Publication Journal: Journal of Psychiatric Research, 2011
By Ian Colman; Yiye Zeng; University of Alberta, Edmonton, Canada

*FYI Living Lab Reports Are Summaries of the Original Research.



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