Life events and response to antidepressants

The present study examined the relationship of life events and response to tricyclic antidepressants among 80 outpatients with unipolar, primary depressions. Participants were randomly assigned to receive either amitriptyline or amoxapine. Events occurring in either the two or 12 months prior to starting treatment (antecedent events) were unrelated to antidepressant response. However, events occurring during the treatment period itself (concurrent events) were significantly related to tricyclic response. Patients evidencing the poorer response reported almost three times as many concurrent events as the more improved patients. A poorer tricyclic response was associated in particular with concurrent events which were undesirable, health related, and perceived as being outside of the patient's own control. It was suggested that the continuing occurrence of stressor events probably interferes with treatment efforts and, therefore, it may be important for the therapist to pay careful attention to the ongoing life stresses of the depressed patient.