Switching medication may help depression

Some people with depression who do not recover with an initial course of anti-depressant therapy can increase their chances of finding relief by trying other drug treatments, researchers are reporting Thursday.

The study is the most extensive of people undergoing multiple treatments for depression.

The findings underscore the benefits of treatment with anti-depressants and its limits. Although 20 percent to 30 percent of the patients who used follow-up regimens recovered, the rest did not.

The report is the second phase of a government-financed study that has tracked more than 2,800 depressed adults under the care of doctors or psychiatrists. In the first phase, reported in January, the researchers found that one in three patients recovered while taking Celexa, an anti-depressant.

In two papers appearing Thursday in The New England Journal of Medicine, the investigators report on a subset of those who did not recover. Those patients went on to complete a different round of treatment.

Experts said the combined recovery rate from the two phases was not certain, because hundreds of the patients who started the trial did not proceed to the second phase.

The study included no comparison group. In most studies of depression, 10 percent to 30 percent of the subjects recover spontaneously when taking placebo pills.

"The importance of this was that it focused on remission, not response, on treatments to help people get well, not just better," said Dr. Thomas R. Insel, director of the National Institute of Mental Health, which financed the study. "And these trials provide doctors and patients with extensive information to help find the best strategies."

Many of the more than 20 researchers involved in the study have consulted widely with manufacturers of antidepressants, but the authors said the companies played no role in interpreting the data or writing the papers.

The researchers emphasized that the doctors treating the people in the study paid careful attention to dosages and side effects and that the patients stuck with their drug therapies for up to 14 weeks before giving up, more than twice as long as many patients do.