A bit of caffeine may help the antidepressants go down

Introduction

The number of antidepressants prescribed in the U.S. has increased rapidly in the past two decades. In 2013, nearly one in eight Americans^[1] filled a prescription for an antidepressant drug. This trend is not limited to the U.S Around the globe, more and more people are taking antidepressant drugs to treat major depressive disorder.

These drugs are not without their drawbacks. Their use is often accompanied by adverse effects^[2], their magnitude of effect may not much larger than placebo^[3], and they take a long time to work^[4]. One typical protocol that physicians use includes switching the drug if it causes adverse events, or to increase the dosage if there is no noticeable improvement. However, there aren’t any well-known protocols that shorten the time it takes for antidepressants to work.

This can be discouraging for many depressed people, and may be a contributing factor to why antidepressant drugs have a 50% adherence rate^[5] amongst psychiatric and primary care patients. Any intervention that could speed up the rate at which antidepressants work and increase their potency would be valuable as an adjunctive treatment.

Caffeine is the most widely used^[6] psychoactive substance in the world and is known to improve the mood^[7] of people who ingest it. It’s also shown some promise^[8] as an adjunct to antidepressants. However, this has only been demonstrated in animal models. The study under review is the first randomized trial to explore caffeine as an adjunct to antidepressant drugs in humans.

Antidepressants are among the most widely-prescribed psychiatric drugs. While they do work for many people, they often take a long time to do so and may not relieve symptoms in certain individuals. Thus, adjunct treatments that can enhance their potency and reduce the amount of time they need to work would be useful. Caffeine has shown promise in animal models as an adjunct to antidepressant drugs. This is the first trial to examine their efficacy as an adjunct therapy in humans.