Predictors of a medical-offset effect among patients receiving antidepressant therapy

Am J Psychiatry. 1998 Jun;155(6):824-7. doi: 10.1176/ajp.155.6.824.


Objective: Characteristics of patients receiving antidepressant therapy were examined to identify factors that may be associated with a medical-offset effect.

Method: In a retrospective study, the authors analyzed claims data from a large health insurer in New England. The study subjects included 1,661 persons initiating treatment for depression with selective serotonin reuptake inhibitors or tricyclic antidepressants between July 1991 and June 1993.

Results: Patients with anxiety disorders, coronary heart disease, cancer, and chronic fatigue syndrome and those remaining on their initial regimens of antidepressant therapy for at least 6 months were more likely to experience significant reductions in the costs of medical care services. The number of visits to mental health providers had no effect on the costs of medical services.

Conclusions: Specific comorbid conditions and sustained use of antidepressant drugs may be associated with a medical-offset effect for patients receiving treatment for depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / economics
  • Antidepressive Agents / therapeutic use*
  • Anxiety Disorders / epidemiology
  • Comorbidity
  • Coronary Disease / epidemiology
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / economics
  • Depressive Disorder / epidemiology
  • Drug Costs
  • Fatigue Syndrome, Chronic / epidemiology
  • Female
  • Health Care Costs*
  • Health Services / economics
  • Health Services / statistics & numerical data*
  • Hospitalization / economics
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Office Visits / economics
  • Office Visits / statistics & numerical data
  • Outpatient Clinics, Hospital / economics
  • Outpatient Clinics, Hospital / statistics & numerical data
  • Practice Patterns, Physicians' / economics
  • Probability


  • Antidepressive Agents