Responsivity of allergic depressed subjects to antidepressant medication: A preliminary study

The prevalence of allergies in 52 patients with major depression was higher than that reported in the general population. After 8 weeks of treatment with either one of two serotonin reuptake inhibitors (SSRIs) or the heterocyclic antidepressant that we used in the clinical trials, the non-allergic depressed had a significantly greater response than the partial response of the allergic depressed as measured by decreases in HAM-D scores from baseline to the end of 8 weeks. Also, all of the non-allergic depressed responded to antidepressants whereas slightly fewer than one-half of the allergic depressed did so. Moreover, after the 8 weeks there were no differences between the HAM-D scores of the allergic depressed receiving active medication and those receiving placebos whereas the HAM-D scores of the non-allergic were significantly lower than those of the placebo group. Although the results are only preliminary observations, they have clinical implications. There is a need for investigators conducting clinical drug trials and for practitioners to obtain information about each depressed patient's allergy status. The discussion focuses on possible methodologic and other explanations for the lower responsivity of the depressed allergic than the non-allergic to antidepressants and also on the need for additional studies to determine whether the results can be replicated. Depression 3:286–289 (1995/1996). © 1996 WIey-Liss, Inc.