For patients recovering from severe Depression, anxiety, or other serious conditions affecting their mental health, prescription medication can be a crucial tool for managing the most debilitating symptoms that accompany these conditions.
When using antidepressants in the long-term, many patients may experience periods of time in which remission and symptom abatement allows for supervised discontinuation of their chosen medication. Unfortunately, when needed, reinstating antidepressant medication isn’t always effective.
Renske C. Bosman, et al. conducted a systematic review in order to track the magnitude and risk of response failure in patients following reinstatement, the findings of which are deconstructed below.
Reinstating Antidepressant Medication: A Systematic Review
In the past decade, the use of antidepressant medications has risen across the world, with heated debates surrounding antidepressant effectiveness garnering international attention. Recently, researchers from leading medical research institutions across the Netherlands conducted a review geared towards better understanding the lack of cohesion in the narratives surrounding response failure and in measuring the true effectiveness of antidepressant reinstatement.
Background and Methodology
After using antidepressants for a prolonged period of time, many individuals may find that they’ve reached a hard-won instance of remission, as they begin to feel balanced enough to work alongside their providers to wean themselves off antidepressants altogether. But if symptoms return and persist during or following periods of remission, reinstating antidepressant medication may become immediately necessary. Under these circumstances, response failure poses significant risks to those depending on these medications to perform exactly as they did prior to their discontinuation.
It’s posited that response failure can occur for a few reasons; often the effects of an antidepressant can decrease during periods of continuous usage, alongside the possibility that patient response can decrease based on the number of repeated exposures to medication. In this systematic review, researchers examined a third type of response failure, in which patients failed to receive the same benefits after discontinuing and reinstating the same antidepressant medication.
In this systematic review, researchers conducted a search of databases including PubMed, Embase, and trial registers for studies involving patients who had experienced anxiety or depressive disorders, post-traumatic stress disorder (PTSD), or obsessive-compulsive disorder (OCD). Within these studies, researchers gathered data on subsets of patients who reported that they experienced response failure to an antidepressant that had been previously effective in managing their symptoms following a period of cessation from the medication.
Results and Findings
The review found that ten of the studies they examined reported some degree of patient response failure after reinstating antidepressant medication. Within these studies, the rates of response failure varied widely, between 3.8 and 42.9% of patients—and affected all common classes of antidepressants.
As a whole, the review’s results suggested that 16.5% of patients were affected by some level of response failure to a familiar medication. However the reviewers point out that there are many limitations to their review, including inconsistent definitions of response between the studies and the lack of data for antidepressants that came into usage after 2006, the date of the most recent of the ten studies. While more systematic research investigating response failure and its associated risk factors is needed, the data suggests that this phenomenon is “clinically relevant” and should be treated as such by future studies.
How TMS Treatment Helps Patients Experiencing Response Failure
Transcranial magnetic stimulation, commonly referred to as TMS, can work to bridge the gap when prescription medication fails to meet a patient’s fundamental needs. TMS is a highly effective, non-invasive treatment option that delivers magnetic pulses to regions of low activity in the brain. The repeated delivery of these non-convulsive TMS treatments works to reverse the negative effects of under and over excitability in different areas of the brain involved in Depression.
Many studies have shown TMS’ effectiveness in improving the remission or response rates of an array of mental health conditions—including severe cases of medication-resistant major depressive disorder (MDD) and Depression with comorbid psychiatric conditions such as anxiety, as well as potentially for PTSD and panic disorders—all of which were examined within the systemic review above.
Often, the patients who turn to TMS are those who have experienced response failure or severe side effects caused by other forms of treatment. Moreover, TMS can safely be used in conjunction with other forms of therapy including CBT (cognitive behavioral therapy) and prescribed antidepressants in order to provide patients with the most comprehensively beneficial treatment plans.
Overcoming Response Failure with Mid City TMS
If you’ve experienced a failure to respond after reinstating antidepressant medications, Mid City TMS’ effective, non-invasive treatments are here. We help patients restabilize and find long-term relief from symptoms of anxiety and Depression. With just a few weeks of regular treatment, TMS can offer a renewed sense of hope to those who have felt discouraged by other forms of treatment.
Mid City TMS has worked tirelessly alongside many New York residents in the battle against Depression. If you or your loved one is struggling to overcome an unexpected response failure, contact us today to learn more about how TMS can work for you.