| Title | Factors Associated with Concomitant Psychotropic Drug Use in the Treatment of Major Depression: A STAR*D Report. | | Author(s) | Shelton RC, Hollon SD, Wisniewski SR, Alpert JE, Balasubramani GK, Friedman ES, Rush AJ, Trivedi MH, Preskorn SH | | Institution | Department of Psychiatry, Vanderbilt University, Nashville, TN, USA. | | Source | CNS Spectr 2009 Sep; 14(9):487-98. | | Abstract | Introduction: Concomitant psychotropic medication (CPM) treatment is common in persons with major depression (MDD). However, relationships with patient characteristics and response to treatment are unclear.
Methods: Participants with nonpsychotic MDD (N=2682) were treated with citalopram, 20-60 mg/day. Sociodemographic, clinical, and treatment outcome characteristics were compared between those using CPMs at study entry or during up to 14 weeks of citalopram treatment, and non-users.
Results: About 35% of participants used a CPM. Insomnia was the predominant indication (70.3%). CPM users were more likely to be seen in primary care settings (69.3% versus 30.7%), be white, of non-Hispanic ethnicity, married, and have a higher income, private insurance, and certain comorbid disorders. CPM users had greater depressive severity, poorer physical and mental functioning, and poorer quality of life than non-users. Response and remission rates were also lower. CPM users were more likely to achieve >50 mg/day of citalopram, to report greater side effect intensity, and to have serious adverse events, but less likely to be intolerant of citalopram.
Conclusion: CPMs are associated with greater illness burden, more Axis I comorbidities (especially anxiety disorders), and lower treatment effectiveness. This suggests that CPM use may identify a more difficult to treat population that needs more aggressive treatment. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19890231 |
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