Antidepressants are effective in people with both depression and chronic physical diseases
A new study from Aarhus University and Charité – Universitätsmedizin in Berlin shows that antidepressant medicine helps patients with chronic physical diseases, such as cancer or cardiovascular diseases, if they develop depression. These findings are important because medications often become less effective when patients suffer from multiple diseases at the same time.
Almost 25% of patients with chronic diseases, such as cancer, Parkinson's disease, cardiovascular diseases, and diabetes, also struggle with depression. If several diseases occur at the same time, drugs such as antidepressants often become less effective than if a patient is only being treated for a single disease. For this reason, a group of researchers from the Department of Clinical Medicine at Aarhus University and Charité – Universitätsmedizin in Berlin decided to investigate whether patients who both have a chronic physical illness and depression actually benefit from antidepressant medicine.
In the study the researchers compiled and analysed data from 176 clinical trials where the effect of antidepressant medicine was studied. Their findings, which are highly relevant for clinical practice, have now been published in the journal JAMA Psychiatry. And it is good news for chronically ill patients who also develop depression, says Associate Professor Ole Köhler-Forsberg from Aarhus University:
"The conclusion is that when antidepressant medicine is given to a patient who also has chronic physical diseases, the effect is just as good as the effect of antidepressant medicine on ‘pure’ depression," he says.
The study is a collaboration between Ole Köhler-Forsberg and Professor Christian Otte, Director of the Department of Psychiatry and Neurosciences at Charité. And the findings are significant, says Christian Otte: “This is good news for people with depression and physical health problems. Quality of life is often severely impaired, especially by depression. We also know that the course of physical disease is worse in patients who also have depression, so treating those patients with antidepressants in addition to other therapeutic measures can definitely help.”
“And even though it may seem obvious that the medicine works as intended, this is far from given for the chronically ill," says Ole Köhler-Forsberg.
“If a patient has several diseases at the same time, it is well-known that the effect of drugs is reduced. This is a major challenge, because it’s more the rule than the exception that patients will have several diseases at the same time. Therefore, it’s important to determine whether the treatment actually also works for these patients."
Findings might be included in German health guidelines
When a patient is affected by serious chronic physical diseases, having to contend with a depression too can be extra challenging. It is therefore important to determine whether the usual treatments work, explains Ole Köhler-Forsberg:
"Comorbid depression, or depression in people with a physical illness, is so frequent that it’s important we in the healthcare system are sure that we can treat the patients properly, and that we can support both their physical and mental health."
The study is significant, because it is one of the first, that examines the effectiveness of antidepressants in patients with other chronic diseases, explains Professor Christian Otte:
“We were surprised to see how few large-scale studies there are on this topic at all, especially in frequent combinations such as cancer with depression. We believe there is still a lot of research to be done in this area.”
He is backed up by Ole Köhler-Forsberg: "Our study is the first to gather and review all the evidence in an area which is important for all medical specialities, and I hope that our findings can help increase focus on early recognition and treatment of depression in people with chronic physical diseases”
The research teams are already planning future projects to find out whether antidepressants might have other effects beyond improving depression and whether they could also alleviate individual symptoms of other physical health problems that are present at the same time.
The researchers expect the study results to be included in the Nationale VersorgungsLeitlinie (NVL), the German national disease management guidelines, for depression. These guidelines are a joint initiative by the German Medical Association (Bundesärztekammer), the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung), and the German Association of the Scientific Medical Societies (AWMF) aimed at improving the quality of medical treatment in the country.
The research results - more information
- Type of study: Systematic literature overview; an umbrella review that gathers evidence from all published systematic reviews in the field.
- Partners: Several colleagues from Charité – Universitätsmedizin in Berlin, Germany. Primarily Prof. Christian Otte, Prof. Stefan Gold, and Prof. Christoph Correll.
- Read more in the scientific article
Contact
Associate Professor Ole Köhler-Forsberg
Department of Clinical Medicine, Health, Aarhus University
Email: olekoehler@clin.au.dk
Phone: +45 23420661