Antidepressants in the medically ill: prediction of benefits

Although depression secondary to medical illness occurs frequently, little is known about its response to conventional antidepressant therapy. In this retrospective study of 50 patients, the authors assessed the charted therapeutic effect of antidepressants and sought to define pretreatment features associated with good outcome. Half (9/18) of the patients with a previous history of depression improved while only 22% (7/32) of the patients without a previous history of depression showed improvement in mood. Those patients meeting DSM-III criteria for major depressive disorder were no more likely to benefit from antidepressants than were patients meeting criteria for adjustment disorder with depressed mood. The authors conclude that previous history of depression should be considered when assessing risks and benefits for antidepressants for medically ill patients with depressive syndromes.