Do demographic and clinical outcomes differ between antidepressant users and non-users in MS?

Introduction:Multiple sclerosis (MS) is a chronic neurodegenerative condition prevalent in young adults. Depression, a frequent comorbidity in MS, poses a 50% development risk. Antidepressants are pivotal in managing depressive symptoms in MS patients, enhancing mood, improving social interactions, and increasing management of physical health challenges. However, it is crucial to note that while benefits prevail, certain antidepressants might exacerbate MS symptoms, such as fatigue, a prevalent issue in MS itself.

Objective:To investigate demographic and clinical differences between MS patients who use antidepressants and those who do not.

Methods:Data from 241 individuals diagnosed with MS, collected in the Sinapse Clinic and inserted in the BRANDO database, were analyzed. Outcomes included marital and employment status, sleep disturbances, sphincter control, sexual dysfunction, Expanded Disability Status Scale (EDSS), Nine Hole Peg Test – NHPT, walking capacity (Timed 25-Foot Walk Test - T25FWT), cognitive processing speed (Symbol Digit Modality Test – SDMT), and fatigue (Modified Fatigue Impact Scale – MFIS). Depression and anxiety were assessed by Beck Depression and Anxiety Inventory (BDI and BAI) and Hospital Anxiety and Depression Scale (HADS-A and HADS-D). Chi-Square and Independent T-tests compared antidepressant users and non-users.

Results:Differences between groups revealed that antidepressant users had significantly higher EDSS scores (p=0.03), more prevalent sleep disturbances (p=0.013), and higher fatigue levels (MFIS) (p<0.001) compared to non-users. No significant differences were found in demographic outcomes or motor and cognitive functions. Depressive symptoms were significantly higher in the antidepressant user group.

Conclusions:The higher depressive symptoms in the antidepressant-using group suggest the correct screening for medication use. Given that sleep changes and fatigue are associated with depressive symptoms, it is challenging to determine whether these are adverse effects of antidepressants or if they are characteristic of the population using them. Future studies should longitudinally assess the effects of antidepressant treatment in MS-related symptoms.