Treatment of depression for patients with multiple sclerosis in neurology clinics.

UNLABELLED: The objective of this study was to examine the adequacy of antidepressant pharmacotherapy in a sample of patients with multiple sclerosis (MS) treated by neurologists. METHODS: MS patients under the care of neurologists were recruited from a large health maintenance organization. Major depressive disorder (MDD) was diagnosed using a structured telephone interview. Antidepressant treatment data were obtained from the HMO pharmacy database. RESULTS: Study participants included 260 patients with MS treated by 35 neurologists. A total of 67 (25.8%) patients met the criteria for MDD. Among the patients with MDD, 65.6% received no antidepressant medication, 4.7% received subthreshold doses from their neurologists, 26.6% received doses at threshold, and 3.1% received doses exceeding threshold. DISCUSSION: Depression was undertreated by the neurologists treating this sample of patients with comorbid MS and MDD. Potential solutions are discussed.