Hopelessness lingers even though medication improves depression

Washington, Feb 19 : People taking antidepressants for fighting the blues typically see a lot of improvements in their symptoms, one area that lags behind in this is a sense of hopefulness, says a new study.

The study, led by James E. Aikens, Ph.D., associate professor in the Department of Family Medicine at the University of Michigan Health System, suggests that people with depression might still feel a sense of hopelessness even while their condition is improving, which could lead them to stop taking the medication.

"The finding suggests that some patients may become unduly pessimistic and stop adhering to an already-helpful therapy," Aikens said.

He added that the finding is troubling because hopelessness is a strong risk factor for suicide.

In the study, the researchers reviewed 573 patients with depression from 37 practices. They were given an antidepressant, fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft). They were assessed one, three, six and nine months after the treatment began.

Overall, patients' depression responded rapidly to medication, with 68 percent of their improvement occurring by the end of the first month, and 88 percent by three months.

The patients experienced the majority of their improvement in several areas during this time period, including positive emotions, work functioning and social functioning.

Improvements in head, back and stomach pain plateaued during the first month, with little improvement thereafter, because of that, Aikens said, physicians may want to consider additional treatments that directly target pain in depressed patients if these physical complaints persist after the first few weeks of treatment with antidepressants.

With hopefulness, however, the improvement was much more gradual.

Physicians may want to consider cognitive-behavioural strategies, such as teaching patients to identify and challenge the pessimistic thoughts that usually accompany depression, and encouraging them to engage in activities that may improve their mood, Aikens said.

The study is published in the journal General Hospital Psychiatry.

ANI