Black and Hispanic adults with depression may not do as well on drug therapy as whites do, a study suggests.
Researchers found that among nearly 2,700 U.S. adults receiving an antidepressant for major depression, African Americans and Latinos had lower success rates than their white counterparts.
Much of the racial gap was related to the fact that the minority groups were, in general, more disadvantaged and in poorer overall health, the researchers report in the journal Medical Care.
“We found that these two groups tended to be more disadvantaged socioeconomically, had more medical problems, less education and higher unemployment rates,” lead researcher Dr. Ira M. Lesser explained in a statement.
“As a result, they may need more treatment, including talk therapy, to overcome their depression,” said Lesser, of the Harbor-UCLA (University of California Los Angeles) Medical Center.
He and his colleagues based their findings on data from a clinical trial in which depression patients were treated with the antidepressant citalopram (Celexa) for an average of 10 weeks.
Overall, the researchers found, white patients were most likely to respond to the drug, while African Americans had the lowest success rates. Hispanic patients fell in between.
Half of white patients had some symptom improvement after starting the antidepressant, versus 38 percent of black patients.
But when the researchers factored in things like patients’ income and education, as well as co-existing medical conditions, the racial disparities faded. According to Lesser’s team, lower-income minority patients may be surrounded by more stressors—such as crime, discrimination and family problems—that feed their depression and make it less likely that they’ll improve with medication alone.
“Clinicians need to be aware when they are treating African Americans and Latinos, particularly if they come from lower social economic groups, that these patients may need more than medication,” Lesser said.
He added that this is also true of any patient who tries antidepressant therapy without success.
SOURCE: Medical Care, November 2007.
