Pain May Interfere With Depression Improvement

February 20, 2004

Source: Center For The Advancement Of Health

Date:

2004-01-29

Treatment for depression may be stymied in people with moderate to

severe body pain, according to a new study.

Researchers J. Bair, M.D., formerly of the Regenstrief

Institute, and colleagues uncovered the connection by analyzing the

results of a clinical trial of 573 depression patients taking

medications like Prozac, Paxil or Zoloft. Their findings are published

in the journal Psychosomatic Medicine.

Although depression improved in most of the patients after three months

of drug therapy, 24 percent had persistently high depression scores. The

therapy was most likely to fail among those who reported moderate to

severe pain at the beginning of their treatment.

" In particular, the odds of a poor depression treatment response were

twice as high in patients with moderate pain at baseline and three to

four times as high in those with severe pain, " Bair says.

Factors like pain may help explain why antidepressants have a mixed

record of success, Bair says. Between 50 and 70 percent of depressed

patients find only partial relief with their medications.

Researchers have long known that pain and depression often go hand in

hand, but there are few studies of how pain might affect depression

treatment. In the Bair study, more than two-thirds of the patients

reported some degree of pain at the start of their treatment.

Twenty-five percent said their pain was mild, 30 percent had moderate

pain and 14 percent said they had severe pain.

" We believe a treatment model that incorporates assessment and treatment

of both depression and pain is desirable, " Bair says.

I'll tell you where to go!

Mayo Clinic in Rochester

s Hopkins Medicine

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