Study: Bodily Pain May Hinder Effectiveness of Antidepressant Medication

Depressed people with moderate to severe bodily pain may not get the full benefit of antidepressive medication, according to a study reported in the January/February issue of Psychosomatic Medicine.

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.

Dr. Matthew J. Bair, formerly of the Regenstrief Institute in Indianapolis, and his colleagues analyzed data from 573 depressed patients taking the antidepressants Prozac, Paxil or Zoloft.

More than two-thirds of the study participants reported some degree of pain at the start of their treatment. Of those, 25 percent described their pain as mild, 30 percent as moderate and 14 percent as severe.

Although depression improved in most of the patients after three months of drug therapy, 24 percent still had persistently high depression scores. The odds of a poor response to antidepressants were twice as high in patients with moderate pain and three to four times as high in those with severe pain.

Bair said factors like pain might help explain why antidepressants have a mixed record of success, noting that between 50 and 70 percent of depressed patients find only partial relief with their medications.

"We believe a treatment model that incorporates assessment and treatment of both depression and pain is desirable," Bair added.

Other sources: Psychosomatic Medicine 2004: 66;17-22, Health Behavior News Service