- Patients with treatment-resistant major depressive disorder (MDD) are at increased risk of developing a substance use disorder (SUD).
- Risk is higher among those with no history of SUD.
Why this matters
- Treatment-resistant depression is common, with 10%-20% of patients with MDD reporting no response to initial antidepressant therapy and up to 60% unable to achieve remission after treatment.
- Study of 121,669 patients with MDD.
- Funding: Söderström-Königska Foundation; Thuring Foundation.
- 12.8% of the patients had treatment-resistant depression.
- In patients without prior SUD history, treatment-resistant depression was associated with SUD risk:
- ≤1 year after treatment initiation (HR, 1.51; 95% CI, 1.4-1.7).
- >1 year after treatment initiation (HR, 1.39; 95% CI, 1.3-1.5).
- Opioid (HR, 1.9; 95% CI,1.4-2.5) and sedatives (HR, 2.7; 95% CI, 2.2-3.2) were implicated.
- In patients with a history of SUD, treatment-resistant depression was associated with a higher risk for SUD:
- ≤1 year after treatment initiation (HR, 1.23; 95% CI, 1.1-1.4).
- >1 year after treatment initiation (HR, 1.15; 95% CI, 1.0-1.3).
- Sedative (>1 year HR, 2.0 [95% CI, 1.3-3.0]) and multiple substance use (HR, 1.9; 95% CI,1.4-2.5) subcategories were implicated.
- Retrospective design.
Coauthored with Antara Ghosh, PhD