Statins may improve tolerability of antidepressant therapy

1. In a large population-based cohort study, combination therapy of antidepressant therapy with a statin was associated with fewer antidepressant treatment discontinuations.

2. Augmentation of antidepressant therapy with a statin was not associated with any differences in treatment efficacy.

Evidence Rating Level: 2 (Good)

Antidepressants, while effective at treating depression, are often discontinued due to treatment intolerance. There has been recent interest in the exploration of adjunctive medication options to improve treatment tolerance, with statins being proposed as one of these agents. In this population-based cohort study, data from the QResearch registry of 673,177 patients with depression was analyzed to determine if there would be lower rates of discontinuation with combination therapy. The study additionally examined changes on Patient Health Questionnaire (PHQ)-9 scores to determine if combination therapy would be associated with differences in treatment efficacy. In the cohort, 46,482 patients received antidepressant + statin, while 626,335 received antidepressant-only. The results revealed that the combination therapy was associated with reduced antidepressant discontinuations at 2, 6, and 12 months. However, no significant differences were observed in efficacy outcomes measured using the Patient Health Questionnaire (PHQ)-9. Overall, combination therapy with antidepressants and statins appeared to improve the acceptability of antidepressant treatment. Further research will be required prior to making this a standard of care however unless otherwise clinically indicated, especially given no statistical differences in treatment response and the mechanism of the effect remaining unknown. Nonetheless, this study does appear to corroborate prior evidence suggesting a potential role for adjunctive medications to decrease antidepressant discontinuations in the future.

Click to read the study in BMC Medicine

Image: PD

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