When depressed patients don’t respond to drug treatment, they need a better treatment

Those mysterious non-responders

When depressed patients are treated with drugs, some don’t respond. Meanwhile, others actually improve when only given a placebo.

To drug researchers, this seems odd.

Gee…it’s almost as if they can’t understand that depressed patients don’t suffer from a deficiency of Prozac or Zoloft or Cymbalta.

A “great, huge” advantage

In a new study, researchers analyzed seven clinical trials. Subjects with depression received either Cymbalta (Eli Lilly’s SSRI drug), another SSRI drug, or placebo.

Before I go any further, you should know that just three researchers were involved in this study, and two of them had ties to Lilly. So…already you can see where this one is headed.

Depression symptoms were improved in the majority of subjects who took Cymbalta or one of the other SSRI drugs. But more than 15 percent of subjects in these treatment groups showed no improvement at all. In the placebo groups, symptom relief was slight, but gradually improved over the course of the studies.

If Lilly execs were hoping this study would prompt headlines like “Cymbalta crushes depression!” they must have been a little bummed to see this Reuters head going out worldwide: “Some depressed people do worse on drugs.”

Uh oh — apparently somebody cancelled the Cymbalta love-fest.

The Reuters report just made things worse by pointing out that some of the “non-responders” may have found their depression symptoms plunging further when side effects such as poor sleep and stomach problems cropped up.

One expert — identified only as “another expert” who was not involved in the study — told Reuters that researchers are trying to figure out personal characteristics that are typical of patients who respond to SSRI antidepressants. If they could do that… “it would be a great, huge advantage for the field.”

Notice he doesn’t say it would be an advantage for patients. No. It would be a “great, huge” advantage for drug companies. And it would be a SUPER great, huge advantage for researchers who could populate depression studies with only powerful responders.

Well, here’s a clue about responders for “another expert”…

As I already mentioned, nobody has ever suffered from a Cymbalta deficiency. But plenty of depressed patients HAVE suffered from omega-3 deficiency.

Brain cells are coated with fats. And when the fats are omega-3 fatty acids, the cells simply function better. And that includes brain cell receptors that process serotonin, the hormone that regulates our sense of well being.

Last year I told you about a study where just one gram of EPA (an omega-3 fatty acid found in fish oil), taken daily, significantly reduced depression symptoms in patients who had been diagnosed with “persistent depression.”

And here’s the best part: Before the study began, all the patients had been unable to control their depression symptoms with SSRI drugs such as Prozac.

If depressed patients followed the EPA protocol for two months — adding ample amounts of vitamin D3 and B vitamins (especially B-12) — you would probably end up with an impressive set of excellent responders.

Sources: 
“Trajectories of Depression Severity in Clinical Trials of Duloxetine” Archives of General Psychiatry, Vol. 68, No. 12, December 2011, archpsyc.ama-assn.org

“Some depressed people do worse on drugs: study” Genevra Pittman, Reuters, 12/12/11, reuters.com