Antidepressants Are Not Associated With Improved Quality of Life in the Long Run

Summary: Overall, people who used antidepressants to manage depression long-term did not have a better quality of physical or mental health than those with depression who did not use prescription medication to manage their symptoms.

Source: PLOS

Over time, using antidepressants is not associated with significantly better health-related quality of life, compared to people with depression who do not take the drugs.

These are the findings of a new study published this week in the open-access journal PLOS ONE by Omar Almohammed of King Saud University, Saudi Arabia, and colleagues. 

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.

In the new study, the researchers used data from the 2005-2015 United States’ Medical Expenditures Panel Survey (MEPS), a large longitudinal study that tracks the health services that Americans use. Any person with a diagnosis of depression disorder was identified in the MEPS files.

Over the duration of the study, on average there were 17.47 million adult patients diagnosed with depression each year with two years of follow-up, and 57.6% of these received treatment with antidepressant medications. 

Use of antidepressants was associated with some improvement on the mental component of SF-12—the survey tracking health-related quality of life.

However, when this positive change was compared to the change in group of people who were diagnosed with depressive disorder but did not take antidepressants, there was no statistically significant association of antidepressants with either the physical (p=0.9595) or mental (p=0.6405) component of SF-12.

In other words, the change in quality of life seen among those on antidepressants over two years was not significantly different from that seen among those not taking the drugs.

This shows antidepressant pill packets
Assorted tablets and capsules. Credit: Christine Sandu

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

The authors add: “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 efforts to improve the ultimate goal of care for these patients; improving their overall quality of life.”

About this depression and psychopharmacology research news

Author: Hanna Abdallah
Source: PLOS
Contact: Hanna Abdallah – PLOS
Image: The image is credited to Christine Sandu

Original Research: Open access.
Antidepressants and health-related quality of life (HRQoL) for patients with depression: Analysis of the medical expenditure panel survey from the United States” by Omar Almohammed et al. PLOS ONE


Abstract

Antidepressants and health-related quality of life (HRQoL) for patients with depression: Analysis of the medical expenditure panel survey from the United States

Background

Despite the empirical literature demonstrating the efficacy of antidepressant medications for treatment of depression disorder, these medications’ effect on patients’ overall well-being and health-related quality of life (HRQoL) remains controversial. This study investigates the effect of antidepressant medication use on patient-reported HRQoL for patients who have depression.

Methods

A comparative cohort, secondary database analysis was conducted using data from the United States’ Medical Expenditures Panel Survey for patients who had depression. HRQoL was measured using the SF-12 and reported as physical and mental component summaries (PCS and MCS). A cohort of patients that used antidepressant medications were compared to a cohort of patients that did not. Univariate and multivariate difference-in-differences (D-I-D) analyses were used to assess the significance of the mean difference of change on the PCS and MCS from baseline to follow-up.

Results

On average, 17.5 million adults were diagnosed with depression disorder each year during the period 2005–2016. The majority were female (67.9%), a larger proportion of whom received antidepressant medications (60.5% vs. 51.5% of males). Although use of antidepressants was associated with some improvement on the MCS, D-I-D univariate analysis revealed no significant difference between the two cohorts in PCS (–0.35 vs. –0.34, p = 0.9595) or MCS (1.28 vs. 1.13, p = 0.6405). The multivariate D-I-D analyses ensured the robustness of these results.

Conclusion

The real-world effect of using antidepressant medications does not continue to improve patients’ HRQoL over time. Future studies should not only focus on the short-term effect of pharmacotherapy, it should rather investigate the long-term impact of pharmacological and non-pharmacological interventions on these patients’ HRQoL.

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  1. I have had depression since I was 17. If I did not take my medication I would not even get out of bed to go to work. In fact I probably would have already taken my own life. This article seems like bullshit. It’s as bad as the crap psychology today publishes.

  2. Wouldn’t be surprised to find big pharma and the psycho-babble profession would be upset with this news

  3. Basically you have to distinguish between three types of depressive illness to gain much from such studies. DSM-5 does not make this distinction.

    1. Reactive states triggered by significant past or current stresses in life.
    2. Depressive illness that is clearly familial without such stresses- that is genetic.
    3. Mixed states.

    My experience is the only the familial form shows a clear response to antidepressants.

  4. Since SF-12 is patient reported, it is literally the opposite of meaningful data, especially given that neurological Depression often includes Anosognosia, hence most Depressed individuals only ever enter into treatment by the encouragement or force of others in their lives, for example, following a self-harm attempt. If you want the real story, ask families and friends how patients are doing in the long run, whether they are more constructive. This toxic, superstitious subjectivism polluting Neuroscience of late tells me the editors are not being vigilant against misinformation coming from anti-scientific religious sources and colluding insurance interests attempting to demedicalize and defund expensive pharmaceutical solutions for the poor.

    1. I am not a scientist, but this abstract was absolutely shocking to me as someone who lives with someone who (with encouragement) is treating anxiety and depression with prescription medication. I opened the comments section hoping to see a take like yours, from someone with a good explanation, because this conclusion seems absurd to me. Thank you for your input. If self reported data is as meaningless as you suggest, this article is sinister misinformation.

      1. This article and headline is extremely misleading.

        The data tracked does not account for how long a person has been on medication, if they managed to get the right dosage / medication, nor if they followed the prescribed medication routine. So given this, the only thing they would be able to say is that medication does not continuously increase happiness infinitely. Medication changes baselines, that’s all they are meant to do. At best, this is hypothesis generating for further study. Granted, this was mentioned in the final quote by the author, but not spoken of directly.

        Publishing this along with the other outlets without examination is borderline sadistic; imagine how many people were dissuaded from exploring medication options by titles and article such as this.

        Please do better next time. Advocate for mental health interventions and improvements to our health systems so people can get the help they need. People in the US (which the data are based on) are economically locked out of opportunities for mental health help; not to mention the social stigma surrounding this topic that this article contributes to.

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