Factors associated with pharmaco resistance in major depressive disorder
DOI:
https://doi.org/10.62438/tunismed.v103i12.6274Keywords:
Depressive disorder, Drug resistance, Antidepressants, Prospective studyAbstract
Background: Depressivedisorderis a commonpsychiatricdisorderthatrepresents a major public healthproblem. The failure of pharmacologicaltreatmentremainsfrequent, resulting in significantsocio-professionaldisability and high economiccosts. The objective of ourworkwas to specify the rates of resistance and remissionunderantidepressants and to determine the factorsassociatedwithdrugresistance in thisdisorder.
Methods: It was a prospective, longitudinal, analyticalstudyconducted in the psychiatrydepartment of the Military Hospital of Tunis in patients consulting for a depressivedisorder. The participants were put on antidepressantswith a regularevaluation of the response to the treatmentthrough the Hamilton depressionscale. The absence of responseaftertwo successive antidepressantswasconsidered as resistance to antidepressanttreatment.
Results: Our studyincluded 80 patients, of whom 13 wereexcluded and 67 completed the study. The meanage of the final samplewas 42.2 yearswith a slight male majority of 56.7%.
The resistance rate was 28.4%. There was a significant association of the resistantcharacter of the depressionwith the followingfactors: severity of the depressiveepisode (p<0.001), duration of the depressivesymptomatology (p=0.026), belonging to a militaryfamily (p=0.009), presence of a non-addictive psychiatriccomorbidity (p=0.005), particularly an anxietydisorder (p=0.003) and the presence of a post-traumatic stress disorder (p=0.007).
Conclusion: This studyunderlines the importance of early and adequate management of resistantdepression, whichremainsfrequent. There are manypredictivefactorsthat must bedetected at an early stage in order to adapttherapeuticstrategies.
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