A study by a team in Saudi Arabia has found that in the long run, using anti-depressants is not associated with a significantly better health-related quality of life, compared with people with depression who do not take the medication.
The findings by Omar Almohammed of King Saud University, Saudi Arabia, and colleagues, were published in the journal PLOS ONE.
It is generally well known that depression disorder has a significant impact on patients’ health-related quality of life (HRQoL). While studies have shown the efficacy of anti-depressant medications for treating depression, these medications’ effects on patients’ overall well-being and HRQoL remains controversial.
In the latest study, the researchers used data from the 2005-2015 United States’ Medical Expenditures Panel Survey (MEPS), a large longitudinal study that tracks the health services used by Americans. Anyone with a diagnosis of depression disorder was identified in the MEPS files.
Over the duration of the study, on average 17.47m adult patients were diagnosed with depression annually, with two years of follow-up: 57.6% of these received treatment with anti-depressant medications.
Use of anti-depressants was associated with some improvement on the mental component of SF-12 – the survey tracking health-related quality of life. However, when this positive change was compared with the change in the group diagnosed with depressive disorder but who did not take anti-depressants, there was no statistically significant association of the medication with either the physical (p=0.9595) or mental (p=0.6405) component of SF-12.
In other words, the change in quality of life among those on anti-depressants over two years was not significantly different from that among those not taking the drugs.
The study was not able to separately analyse any subtypes or varying severities of depression. The authors say future studies should investigate the use of non-pharmacological depression interventions used in combination with anti-depressants.
“Although we still need patients with depression to continue using their anti-depressant medications, long-term studies are needed in evaluating the actual impact for pharmacological and non-pharmacological interventions on these patients’ quality of life,” they added.
“With that being said, the role of cognitive and behavioural interventions on the long term-management of depression needs to be further evaluated in efforts to improve the ultimate goal of care for these patients; improving their overall quality of life.”
Study details
Antidepressants and health-related quality of life (HRQoL) for patients with depression: Analysis of the medical expenditure panel survey from the United States.
Omar Almohammed, Abdulaziz Alsalem, Abdullah Almangour, Lama Alotaibi, Majed Al Yami, Leanne Lai.
Published in PLOS ONE on 20 April 2022.
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.
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