2 anti-depressants no more effective than 1 anti-depressant research shows

Mixing two SSRI anti-depressants will not give you better results than going with one SSRI anti-depressant according to an article in MedPage Today, APA: Two Drugs No Better than One for Depression.

In a large trial sponsored by the National Institute of Mental Health (NIMH), patients who received either of two dual-drug combinations were no more likely to achieve responses or remission at 12 or 28 weeks than those treated with a single agent, said Madhukar Trivedi, MD, of the University of Texas Southwestern Medical Center in Dallas.

People taking two drugs were no more likely to see a remission of symptoms than people taking a single drug. Patients did register one kind of difference from the use of 2 drugs, but it could hardly be characterized as a positive difference.

In the current trial, Trivedi said, the only difference for patients with combination therapy was to “increase the burden of side effects.”

A person taking 1 SSRI anti-depressant is no more apt to suffer a relapse than a person taking 2 SSRI anti-depressants. The hope that 2 drugs might prove more effective than one has proven unfounded.

The federally sponsored STAR*D trial — which Trivedi helped lead — shocked many psychiatrists by showing that only about 30% of depressed patients given standard single-drug antidepressants achieved remission, and that substituting other drugs increased remission rates by progressively smaller increments.

Prescribing patients multiple drugs, or polypharmacy as it is called, is a formula that is notorious for its negative outcomes. These studies involving the coupling of anti-depressants show us that in adding anti-depressants one is not increasing positive results. Clinicians need to take note.

The lack of improvements seen in the use of 2 anti-depressants demonstrate yet another reason why more drug-free treatment options for depression need to be explored and developed. If 2 anti-depressants work no better than 1 anti-depressant, who knows how much more effective 0 anti-depressants might prove to be in the long run. If anti-depressant drugs are not the psychiatric panacea they were once taken to be, certainly it is time to look at how more people might be able to better cope without hobbling along on the crutch of a ‘happy pill’.

4 Responses

  1. This reminds me of an old expression, referring to the philosophy of government, “Why build one bridge, when you can build two for twice the cost?”

    Not a great analogy, considering bridges serve a purpose…. have a function!

    Duane Sherry, M.S.

    • Well, in a sense, maybe it is a good analogy. People are labeled “mental ill” because they are thought to display “symptoms” of an “illness” that interferes with their function, or, same thing, purpose. This takes us to a big philosophical question that has never been entirely resolved, namely, what is the purpose of a human being? I know that psychiatry only deals with the subject in a facile manner (e.g. the function of a barbour is cutting hair), but the matter remains unresolved. Chiefly the functions we tend to adapt and adopt tend towards the absurd. I think it is often this absurdity that gets people into trouble. Some people, that is, have a difficult time adjusting to a ridiculous role.

  2. Not to worry about two antidepressants working no better than one…
    Pharma is actively expanding the market, with its introduction of “adding Abilify” (and other neuroleptics to the mix…

    Let me get this straight…
    If holding serotonin in the neurotransmitter doesnt’ get the job done… add a chemical that inhibits the reception of dopamine? Dopamine being the ‘king’ of feel-good chemical… Keeping dopamine OUT of the brain is the answer?

    How bright are these people… Not too bright!

    Psychiatry continues to attempt to drug the brain to health…. It doesnt’ work, but they keep doing it anyway…

    The classic defintion of insanity: “To keep doing the same thing, over-and-over, while expecting different results.”

    Is psychiatry insane?

    Duane Sherry, M.S.

    • Abilify for depression is scary. The problem is that the literature blows all these things up. A person can’t just be depressed, he or she has to be majorly depressed. Now we are at liberty to harm two groups of people, not just one. The idea is that drug treatment is seen as a necessary trade off for some sense of mental stability by some people. You’ve got people saying 25 years gone, nope, not too high a price to pay. They still shock people for depression, too. I would draw a comparison with hitting people in the head with a hammer. Such a treatment could be seen as “working”, too. Anybody want to recommend it?

      Both the dopamine and the seratonin imbalance theories have been disproven anyway. They are based upon what the drugs do, and not on anything that was going on in the brain of the patient. These doctors must be creatures of habit though. They are so slow when it comes to trying new and effective methods of treatment. I think they are more interested in avoiding civil suits than they are in improving the wellbeing (mental and physical) of their patients.

      I believe I’ve heard it said before that there is no high like a natural high. Nature is the best medicine. Nice try, doctors, but psychiatric drugs are not medicinal. As these drugs don’t “fix” the problem, and they tend to make the problem even worse, maybe what’s needed isn’t another drug. Maybe what’s needed is another approach to treatment. Millions of years of evolution are more apt to be damaged than aided by the addition of a chemical compound. Give evolution a chance, and don’t rush towards annihilation, please.

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