Exploring the incidence of inadequate response to antidepressants in the primary care of depression

• Published in: European neuropsychopharmacology 2024-06, Vol.83, p.61-70
• Main Authors: Abrahams, Abigail B, Beckenstrom, Amy C, Browning, Michael, Dias, Rebecca, Goodwin, Guy M, Gorwood, Philip, Kingslake, Jonathan, Morriss, Richard, Reif, Andreas, Ruhé, Henricus G., Simon, Judit, Dawson, Gerard R
• Format: Article
• Language: English
• Subjects: Antidepressant; Depression; Treatment; Treatment-resistant depression
• ISSN: 0924-977X; 1873-7862
• DOI: 10.1016/j.euroneuro.2024.04.005

Data from the UK suggests 13–55 % of depression patients experience some level of treatment resistance. However, little is known about how physicians manage inadequate response to antidepressants in primary care. This study aimed to explore the incidence of inadequate response to antidepressants in UK primary care. One-hundred-eighty-four medication-free patients with low mood initiated antidepressant treatment and monitored severity of depression symptoms, using the QIDS-SR16, for 48 weeks. Medication changes, visits to healthcare providers, and health-related quality of life were also recorded. Patients were classified into one of four response types based on their QIDS scores at three study timepoints: persistent inadequate responders (5), and 20 % of patients had a persistent inadequate response. Regardless of treatment response, 96 % (n = 176) of patients did not visit their primary care physician over the 40-week follow-up period. These results suggest that despite receiving treatment, a considerable proportion of patients with low mood remain unwell and fail to recover. Monitoring depression symptoms remotely can enable physicians to identify inadequate responders, allowing patients to be reassessed or referred to secondary services, likely improving patients’ quality of life and reducing the socioeconomic impacts of chronic mental illness.