This depression drug is linked to increased mortality risk

A study by scientists from Rutgers University and Columbia University has found that adults with depression who started treatment with newer antipsychotic medications faced a higher risk of death compared to those who added a second antidepressant.

The findings, published in PLOS ONE, highlight concerns about the use of antipsychotics in managing depression, especially given their potential health risks.

Depression is typically treated first with antidepressants, but many people do not experience sufficient improvement with their initial medication. When this happens, doctors may switch the patient to another antidepressant or recommend adding a second treatment.

This augmentation can involve a second antidepressant or newer antipsychotic drugs, such as aripiprazole, quetiapine, or olanzapine.

Antipsychotics, however, come with well-documented risks. These include serious side effects such as weight gain, metabolic issues, and an increased mortality risk. Previous research has shown that older adults with dementia who take antipsychotics face a more than 50% higher risk of death.

This study looked at data from 39,582 Medicaid patients aged 25 to 64 between 2001 and 2010, linking their records to the National Death Index.

These individuals had been treated with a single antidepressant but then required additional therapy. The study compared patients who started on a newer antipsychotic with those who added a second antidepressant.

The results showed a 45% relative increase in mortality risk among those who initiated treatment with an antipsychotic. For this group, the increased risk translated to one additional death for every 265 people taking the medication for one year.

Although these findings need further confirmation through large-scale randomized trials, they raise important concerns.

The study suggests that physicians should be cautious when prescribing antipsychotics to patients with depression. The potential benefits of these drugs are modest and often debated, while the risks, including increased mortality, are significant.

The research also highlighted a common issue in treatment practices: many patients in the United States begin antipsychotic therapy before completing a full trial with a single antidepressant.

Most antidepressants require four to six weeks to reach their full effect, but some patients move to riskier treatments prematurely, contrary to drug guidelines and best practices.

These findings stress the importance of exploring safer, evidence-based options first. Physicians should reserve newer antipsychotics for cases where patients have not responded to less risky alternatives, ensuring that the benefits clearly outweigh the risks.

For individuals managing depression, it’s crucial to discuss treatment options thoroughly with their healthcare providers to make informed decisions about their care.

As research continues, this study serves as a reminder of the need for careful prescribing practices and the importance of prioritizing patient safety in the treatment of depression.

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