Researchers from Rutgers University and Columbia University have discovered that newer antipsychotic medications could significantly increase the risk of death in adults with depression.
This finding, published in PLOS ONE, raises concerns about how these drugs are used as part of treatment plans for depression.
Depression is a widespread mental health condition that can seriously affect a person’s life. Antidepressants are usually the first choice for treatment, but they don’t work for everyone. When one antidepressant fails, doctors often look for other options.
These include switching to another antidepressant or adding a second medication to boost the effect of the first. The added medication could be another antidepressant or an antipsychotic like aripiprazole, quetiapine, or olanzapine.
Antipsychotics can be helpful for some people, but they also come with serious side effects. In older adults with dementia, these drugs are already linked to a higher risk of death. This new study wanted to see if the same risk exists for younger adults with depression.
The researchers studied data from 39,582 Medicaid patients between the ages of 25 and 64, spanning the years 2001 to 2010. By connecting this data to the National Death Index, they tracked how many people died and whether the type of medication affected the outcome.
The patients were split into two groups: those who added a newer antipsychotic to their treatment and those who added a second antidepressant.
The results were alarming. People who took a newer antipsychotic had a 45% higher risk of death compared to those who added another antidepressant.
This means that for every 265 people treated with an antipsychotic for one year, one extra person would die due to the medication.
These findings highlight the need for caution. Antipsychotics may offer some benefits, but these benefits are modest and must be weighed against the significant risks.
Many doctors in the U.S. prescribe antipsychotics for depression without fully exploring other options, such as trying a single antidepressant for the recommended four to six weeks. This goes against treatment guidelines and the drug manufacturers’ recommendations.
The researchers emphasize that antipsychotics should only be used when all safer options have been tried and failed. They suggest doctors and patients carefully weigh the risks and benefits before making decisions about treatment.
This study serves as a reminder to prioritize safer strategies when managing depression, especially since the health risks of antipsychotics are substantial.
The study also calls for further research to confirm these findings, ideally through a large, randomized controlled trial funded by public health organizations.
Until then, both doctors and patients should remain cautious about using antipsychotics for depression and focus on minimizing risks while aiming for effective treatment outcomes.
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