Hope May Take Time After Depression

Feb. 21, 2008 -- New depression research confirms that antidepressants work, but hopelessness may take longer to lift than other symptoms.

Based on those findings, the researchers make two suggestions:

• Patients should be followed closely for several months after their mood improves if they were particularly pessimistic before starting antidepressant treatment.
• Therapy may help heal hopelessness by teaching patients to challenge their pessimistic thoughts.

So say the University of Michigan's James Aikens, PhD, and colleagues in the January/February edition of General Hospital Psychiatry.

Depression Study

Aikens' team reviewed data on 573 U.S. adults (average age: 46) who had been diagnosed with depression.

First, the patients rated their mood, hopelessness, ability to function socially and at work, and physical complaints including joint pain, insomnia, and low energy.

Next, they were randomly assigned to take Paxil, Prozac, or Zoloft, which belong to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs).

The patients repeated their ratings one, three, six, and nine months after starting antidepressant treatment.

Depression Treatment Worked

All of the antidepressants made a big difference easing the patients' depression.

First, physical symptoms eased and mood improved; those gains happened within three months. Hopelessness also gave way, but it took longer to have its maximum impact.

Hopeless patients may quit taking their antidepressants. Hopelessness is also a suicide risk factor, so Aikens' team suggests targeting hopelessness with therapy as well as antidepressants.

The study wasn't about which antidepressant was best. The results aren't broken down among the three drugs, and the findings may not apply to antidepressants that aren't SSRIs.

Funding for the study came, in part, from Eli Lilly and Co., which makes Prozac. In the journal, the researchers report financial ties to various drug companies, including Lilly and Pfizer, which makes Zoloft.