By: KARI OAKES, Family Practice News Digital Network JUNE 20, 2016
koakes@frontlinemedcom.com
On Twitter @karioakes

SCOTTSDALE, ARIZ. – Simple, effective, nonpharmacologic therapies can significantly augment pharmacotherapy for patients with treatment-resistant depression, according to Dr. Mark Hyman Rapaport. More complex complementary approaches are being explored and may hold promise as part of the future of precision medicine, but well-tested strategies can still help many patients, he said.

Speaking at a session focused on treatment-resistant depression at a meeting of the American Society of Clinical Psychopharmacology, Dr. Rapaport, chairman of the department of psychiatry and behavioral sciences and Reunette W. Harris Professor at Emory University, Atlanta, began with the basics.

Massage can effectively improve mood for individuals with depression as well. In a study of HIV-positive individuals with major depressive disorder and on stable medication, those who received weekly massage had a 33% decrease in HAM-D scores, compared with a 12% increase for those receiving light touch, and a 9% decrease for those on a wait list who received neither touch nor massage (P less than .05). The response rate of 40% for those receiving massage also was significantly higher than the 6.3% for those receiving light touch and the 14% for those on the wait list (P less than .05).

Recently completed unpublished work by Dr. Rapaport and his colleagues involving patients with generalized anxiety disorder also showed significantly greater improvement on a self-rating scale for anxiety for those receiving twice-weekly Swedish massage therapy, compared with those receiving light touch.

“Our patients – their symptoms aren’t just what we see on the monitors – they deal with quality of life, they deal with functioning,” said Dr. Rapaport, “so there are many things that we as clinicians need to look at,” he said at the meeting. “The key is this: There’s a slowly increasing but limited data set for [treatment-resistant depression]. We need to find the right treatments for the right subjects. “

The ASCP meeting was formerly known as the New Clinical Drug Evaluation Unit meeting. Dr. Rapaport reported no relevant financial conflicts.

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