These depression drugs may lead to higher death risk
In a new study published PLOS ONE, researchers found an increased death risk in adults with depression who initiated augmentation with newer antipsychotic medications compared to a control group that initiated augmentation with a second antidepressant.
The study is from Rutgers and Columbia University. One author is Tobias Gerhard.
Although antidepressants are the first-line pharmacological treatment for depression, many people do not respond to the first course of treatment.
Subsequent treatment options include switching to another antidepressant followed by various augmentation strategies, including augmentation with a second antidepressant and augmentation with newer antipsychotics, such as aripiprazole, quetiapine, and olanzapine.
Previous research has shown that antipsychotics have well-recognized and often serious adverse effects, including a more than 50% increased mortality risk in older adults with dementia.
In the study, the team looked at data of 39,582 Medicaid beneficiaries ages 25 to 64 from 2001 to 2010. After a period of treatment with a single antidepressant, the patients initiated either augmentation with a newer antipsychotic or with a second antidepressant.
The researchers found a 45% higher mortality risk in those initiating a newer antipsychotic.
The finding suggests that physicians should consider prescribing antipsychotics to adults with depression carefully, as the potential health risks are substantial and the benefits are quite modest and controversially debated.
The team says it is well-known that most antidepressants take about four to six weeks to be fully effective.
However, contrary to the drug label and treatment guidelines, many patients in the United States initiate antipsychotic treatment for depression without having completed an adequate prior trial with a single antidepressant.
The current results emphasize the importance of considering newer antipsychotics only after non-response to less risky, evidence-based treatment options has been established.
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