Depression improvement and pain

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Depression improvement and pain

28 Jan 2004

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.

³In 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,² 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.

³We believe a treatment model that incorporates assessment and treatment of

both depression and pain is desirable,² Bair says.

The study was supported by the Health Resources and Service Administration

and Eli Lilly and Co.