Antidepressants and health-related quality of life (HRQoL) for patients with depression: Analysis of the medical expenditure panel survey from the United States

Abstract

Background Despite the empirical literature demonstrating the efficacy of antidepressant medications for treatment of depression disorder, these medications’ effect on patients’ overall well-being and health-related quality of life (HRQoL) remains controversial. This study investigates the effect of antidepressant medication use on patient-reported HRQoL for patients who have depression. Methods A comparative cohort, secondary database analysis was conducted using data from the United States’ Medical Expenditures Panel Survey for patients who had depression. HRQoL was measured using the SF-12 and reported as physical and mental component summaries (PCS and MCS). A cohort of patients that used antidepressant medications were compared to a cohort of patients that did not. Univariate and multivariate difference-in-differences (D-I-D) analyses were used to assess the significance of the mean difference of change on the PCS and MCS from baseline to follow-up. Results On average, 17.5 million adults were diagnosed with depression disorder each year during the period 2005–2016. The majority were female (67.9%), a larger proportion of whom received antidepressant medications (60.5% vs. 51.5% of males). Although use of antidepressants was associated with some improvement on the MCS, D-I-D univariate analysis revealed no significant difference between the two cohorts in PCS (–0.35 vs. –0.34, p = 0.9595) or MCS (1.28 vs. 1.13, p = 0.6405). The multivariate D-I-D analyses ensured the robustness of these results. Conclusion The real-world effect of using antidepressant medications does not continue to improve patients’ HRQoL over time. Future studies should not only focus on the short-term effect of pharmacotherapy, it should rather investigate the long-term impact of pharmacological and non-pharmacological interventions on these patients’ HRQoL.

Changes in treatment outcomes in patients undergoing an integrated psychosomatic inpatient treatment: Results from a cohort study

“…Finally, the effect of antidepressants on HRQoL might not be as sustained at 12- or 24-month follow-up. Consistent to this explanation, a recent study in patients with MDD comparing a cohort with and without intake of antidepressants ( 43 ) showed that the real-world effect of antidepressant intake does not continue to improve patients’ HRQoL over time, and the effect of antidepressants on improvements of HRQoL was limited to the initial 2–3 months of treatment. However, the HRQoL scores did not sufficiently improve in long-term compared to the general population ( 44 , 45 ).…”

Symptomatic versus disease‐modifying effects of psychiatric drugs

“…Hence proof via randomized data is missing. Some observational data on quality of life do not show notable benefit with antidepressants 44 …”

“…Some observational data on quality of life do not show notable benefit with antidepressants. 44 Lithium is different from most other psychiatric drugs (outside of the mood stabilizer class of lamotrigine and valproate and carbamazepine) in that it has clear randomized data that it improves course of illness (prevents episodes), extends life, and prevents hospitalizations. 33 Such randomized data do not exist in long-term studies, meaning 1 year or longer, with antidepressants for unipolar depression, antipsychotics for schizophrenia, or anxiolytics for anxiety conditions.…”

Strategie dlouhodobé léčby psychofarmaky a jejich vysazování

“…Zarážející je informace britských autorů Cruickshanka, MacGillivraye a Bruce (2008), jejichž výzkum poukázal, že odhadem asi třetina lidí ve Velké Británii, užívajících antidepresiva déle než dva roky, již nenaplňuje žádnou klinickou indikaci k dlouhodobému podávání medikace, opírající se o důkazy. A jiná metaanalýza zase ukazuje, že kvalita života pacientů v dlouhodobé medikaci antidepresivy se nevylepšuje oproti neléčeným kontrolám (Almohammed et al, 2022). V tomto bodě budeme potřebovat pečlivé dlouhodobé studie i kazuistické záznamy, abychom lépe porozuměli podstatě dlouhodobého podávání antidepresiv.…”