One Antidepressant Ineffective? Study Suggests Trying Another

Switching medications can help relieve symptoms.

When one antidepressant fails to alleviate symptoms of depression, switching to or adding another one often does the trick, researchers say.

"The message to the patient is: 'Hang in there,'" said study leader A. John Rush, M.D., professor of psychiatry at the University of Texas Southwestern Medical Center in Dallas. "If the first treatment does not relieve your symptoms, consider changing medications or adding another medication. For a depressed individual, it may not matter so much what drug is being prescribed, but that the person moves forward and keeps trying."

Working with Rush, clinicians across the country reported that one-third of their depressed patients who used medication experienced relief from symptoms after 14 weeks. Of the rest, some chose to try a different medication. About 25 percent of those patients succeeded in relieving their symptoms after another 14 weeks with a new drug. All told, more than half of the patients benefited from medication by the end of the study.

"If you can hang in there for at least two different treatments, you have better than a 50 percent chance of not just getting better, but getting well," said Rush.

The study also revealed that, even after two drug therapies, nearly half of the patients were still depressed. "We still have a way to go with the 40 percent of people who've had two different drug treatments and still haven't achieved remission," said Rush. "We need better treatments."

The study was published in the March 23, 2006 issue of the New England Journal of Medicine.