Researchers Matthew J. Bair, M.D., formerly of the Regenstrief Institute,
and colleagues uncovered the connection by analyzing the results of a clinical
trial of 573 depression patients taking medications like Prozac, Paxil
or Zoloft. Their findings are published in the journal Psychosomatic
Medicine.
Although depression improved in most of the patients after three months
of drug therapy, 24 percent had persistently high depression scores. The
therapy was most likely to fail among those who reported moderate to severe
pain at the beginning of their treatment.
“In particular, the odds of a poor depression treatment response
were twice as high in patients with moderate pain at baseline and three
to four times as high in those with severe pain,” Bair says.
Factors like pain may help explain why antidepressants have a mixed record
of success, Bair says. Between 50 and 70 percent of depressed patients
find only partial relief with their medications.
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.
In the Bair study, more than two-thirds of the patients reported some degree
of pain at the start of their treatment. Twenty-five percent said their
pain was mild, 30 percent had moderate pain and 14 percent said they had
severe pain.
“We believe a treatment model that incorporates assessment and treatment
of both depression and pain is desirable,” Bair says.
