Assessment of Health-Related Quality of Life, Patient-Reported Mental Health Status and Psychological Distress based on the Type of Pharmacotherapy used Among Patients with Depression

Background: Pharmacotherapy with antidepressants and/ or anti-psychotics helps to relieve depression and improve the mental health and overall quality of life of individuals suffering from this disease. There is sufficient data from clinical trials that show the safety and efficacy of these medications. However there is lack of clear guidelines for prescribing these medications and there is a gap in literature on studies which determine the effect of these medications on the overall wellbeing of individuals.;Objective: 1. To compare the effect of the specific class of antidepressants on the health-related quality of life, psychological distress and patient reported mental health status (PR-MHS) of individuals suffering from depression who are on monotherapy.2. To compare the above mentioned outcomes in patients on monotherapy and those who add-on/switch therapies.;Methods: This retrospective, observational study used the Medical Expenditure Panel Survey database. Individuals suffering from depression (ICD-9-CM: 296, 300, and 311) and those taking antidepressants and/or antipsychotics since the beginning of the panel were identified. Difference in SF-12 scores, K6 scores and PR-MHS over a years time was categorized into "improve", "unchanged scores" and "decline" in scores. A multinomial logistic regression model was built to examine the association between the class of medications and HRQOL, psychological distress and mental health status. Results: A total of 804 patients met the study inclusion criteria, among which 688 patients were on monotherapy and 116 on add-on/switch therapy. Among patients only on monotherapy, no significant difference was observed in their tendency to show improvement or decline on PCS-12, K6 and PR-MHS scores based on the class of antidepressants. However patients on SNRIs (OR 0.361, 95% CI 0.114--0.950) and TCAs (OR 0.337, 95% CI 0.155--0.730) were significantly less likely to show improvement on MCS-12 scores as compared to those on SSRIs. Further, no significant differences were observed in patients on monotherapy and add-on/switch therapy in their likelihood to show improvement or decline on SF-12, K6 and PR-MHS scores.;Conclusion: The results of the study may imply that further research needs to be done to determine the reason for SSRIs to show greater improvement on mental health as compared to SNRIs. Similar results in patients on monotherapy and add-on/switch therapy can suggest that their therapy may keep depressive symptoms under control, which can indicate a good clinical decision by the patients health care providers.