JAMA Psython: How different are the individuals in antidepressant therapy?

Depression, a common mental disorder, is now the second-largest killer of cancer in humans, with an estimated 350 million people worldwide suffering from depression.
The World Health Organization estimates that depression will be the world's largest burden of disease by 2030.
According to data published in The Lancet in 2018, the global incidence of depression is about 6 per cent, while the lifetime risk is 15-18 per cent, meaning that one in five people experience depression at some point in their lives.
half of them live in Southeast Asia and the Western Pacific, including India and China.
, long-term moderate to severe depression can become a serious disease.
most severe cases, depression can lead to suicide.
800,000 people die by suicide each year.
has become the second-largest cause of death among the 15-29 age group.
the basis of antidepressants is mainly to increase the content of monoamine neurotransmitter.
mainly include the following categories: selective 5-serotonin reuptake inhibitors (SSRIs), 5-oxycodone and epinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic and tetrough antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and so on.
, however, not all patients are sensitive and effective against depression drugs.
outcomes of antidepressants can vary based on individual differences, but it is not clear whether the differences are random or determined by specific factors.
, an individual difference in the sensitivity of antidepressants, recently published in jama sub-journal JAMA Psychic, was fully evaluated.
researchers searched for antidepressant use registered in Cochrane, CINAHL, Embase, LILACS, MEDLINE, MEDLINE In-Process and PsycInfo as of March 21, 2019.
was limited to double-blind, randomized placebo-controlled trials, and all participants were given depression scores at the end of the study.
after two groups of logSDs (i.e. antidepressants and placebos) were selected, a random slope mixing effect model was used to estimate the difference between the treatment groups.
used primarily to assess whether individual differences in drug use between groups were related to the severity of baseline depression, the type of antidepressant use, and the year of the study.
results showed that a total of 18,965 participants from 91 trials were included in the study.
, there was no significant difference in response variability between antidepressants and placebos (logSD=1.02; 95% CI, 0.99-1.05).
patients who used SNRIs were 11% more mutated than those who used SSRIs (logSD=1.11; 95% CI, 1.01-1.21).
, the variability of the drug response was not related to the severity of baseline depression or the year the study was conducted.
, the results suggest that a uniform pattern of antidepressant medications cannot be used in depressed patients.
future studies should seek to better assess individual depressive symptoms or biomarkers for individual antidepressant therapy.
: Maslej MM, et al. Individual Differences in Response to Antidepressants: A Meta-analysis of Placebo-Controlled Randomized Clinical Trials. JAMA Psychiatry. Published online February 17, 2021. doi:10.1001/jamapsychiatry.2020.4564MedSci Original Source: MedSci Original Copyright Notice: All noted on this website "Source: Mays Medicine" or "Source: MedSci Original" text, images and audio and video materials, copyrights are owned by Metz Medical, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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