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As
depression symptoms improve with
antidepressants, hopelessness can linger…A
sense of hopefulness does not improve as
quickly as other symptoms
ANN ARBOR, Mich. — People taking medication
for depression typically see a lot of
improvements in their symptoms during the
first few months, but lagging behind other
areas is a sense of hopefulness, according
to new research from the University of
Michigan Health System.
That means people with depression may still
feel a sense of hopelessness even while
their condition is improving, which could
lead them to stop taking the medication.
For many in the study, feelings of
hopefulness did not improve until several
weeks, or even months, after depressive
symptoms lifted, says lead author James E.
Aikens, Ph.D., associate professor in the
Department of Family Medicine at the
University of Michigan Health System.
“The finding suggests that some patients may
become unduly pessimistic and stop adhering
to an already-helpful therapy,” he notes.
This finding is troubling, he says, because
hopelessness is a strong risk factor for
suicide.
The study appears in the January-February
issue of the journal General Hospital
Psychiatry.
Aikens and his team studied 573 patients
with depression from 37 practices. They were
given an antidepressant, either fluoxetine
(Prozac), paroxetine (Paxil) or sertraline
(Zoloft). They were assessed one, three, six
and nine months after the treatment began.
Overall, patients’ depression responded
rapidly to medication, with 68 percent of
their improvement occurring by the end of
the first month, and 88 percent by three
months.
The patients experienced the majority of
their improvement in several areas during
this time period, including positive
emotions, work functioning and social
functioning.
Improvements in head, back and stomach pain
plateaued during the first month, with
little improvement thereafter. Because of
that, Aikens says, physicians may want to
consider additional treatments that directly
target pain in depressed patients if these
physicial complaints persist after the first
few weeks of treatment with antidepressants.
With hopefulness, however, the improvement
was much more gradual. Physicians may want
to consider cognitive-behavioral strategies,
such as teaching patients to identify and
challenge the pessimistic thoughts that
usually accompany depression, and
encouraging them to engage in activities
that may improve their mood, Aikens says.
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