Depression symptoms continue for many despite use of antidepressants
July 8, 2004
by Sheryl Ubelacker

TORONTO (CP) - An estimated two million Canadians have chronic depression and the debilitating condition may be under-treated, a study suggests. It found that fatigue, lack of energy and poor sleep continued to plague many patients despite the use of antidepressants.

The study, conducted by the Canadian Network for Mood and Anxiety Treatments, involved a cross-Canada phone survey earlier this year of more than 6,400 adults and was designed to find out how people diagnosed with depression were faring with their treatments and how depression affected their lives.

Less than one-third of the 434 respondents who said they had been diagnosed with depression and were taking antidepressants reported alleviation of some key symptoms of the condition - fatigue, lack of energy, anxiety and impaired concentration, said Dr. Sidney Kennedy, chief psychiatrist at Toronto's University Health Network and a principal investigator of the study.

Just over half of respondents with depression said their treatments had relieved problems with poor sleep - either insomnia or sleeping too much - "completely or almost completely," the study found.

Fatigue and lack of energy were cited most often as the symptoms that affected ability to work, perform household tasks and engage in social activities, Kennedy told a news conference Thursday.

He said the study is different from most others on depression because it dealt with a cross-section of Canadians both with and without the condition, not just patients.

However, no samples of responses from those without depression were given.

The study, headed by Kennedy and colleagues at McGill University in Montreal and the University of British Columbia in Vancouver, was funded with a $120,000 grant from Biovail Corp., the Mississauga, Ont.-based maker of the antidepressant Wellbutrin SR. Kennedy stressed that Biovail had no input into the results of the study, parts of which are still being analysed for future release.

"The field is moving from just thinking about symptoms and whether your sleep has improved or whether your anxiety symptoms are a little less to actually asking the question: 'How are you doing in your everyday life? How are you managing in the workforce? Are you able to pay the bills when the envelopes come in or are they piling up in your living room?'

"We're interested in the translation into life of our treatments," he said. "So we wanted to know how people felt their treatments had helped them."

Kennedy said the study suggests that less than half of those taking the most commonly prescribed antidepressants - which work by regulating levels of mood-controlling serotonin levels in the brain - are enjoying full remission of symptoms.

The finding means doctors need to look at changing how depression is treated, he said. That may involve prescribing combination therapies, such as an antidepressant coupled with psychotherapy or two or more medications, which each deal with different symptoms.

The study's conclusions also suggest a need for drugs that target different centres in the brain associated with depression, he said.

"As a physician," said Kennedy, "I think there is an emerging consensus that we can get people out of the worst of depression, but often people are left in a kind of partially treated (state) with residual symptoms.

"And I think the real challenge is to treat people to a state of remission, where their quality of life is as good as it ever was," he said. "We need to be looking at more treatments that can take more people to that state of wellness."