Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-24T09:08:19.715Z Has data issue: false hasContentIssue false
  • English
  • Français

The early improvement of depressive symptoms as a potential predictor of response to antidepressants in depressive patients who failed to respond to previous antidepressant treatments. Analysis of naturalistic data

Published online by Cambridge University Press:  15 April 2020

M. Bares ,
T. Novak ,
M. Kopecek ,
P. Stopkova ,
J. Kozeny  and
C. Höschl
M. Bares*
Affiliation:
Prague Psychiatric Center, Ustavni 91, Prague 8, Bohnice, 181 03, Czech Republic The Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University, Ruska 87, Prague10, 100 00, Czech Republic
T. Novak
Affiliation:
Prague Psychiatric Center, Ustavni 91, Prague 8, Bohnice, 181 03, Czech Republic The Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University, Ruska 87, Prague10, 100 00, Czech Republic
M. Kopecek
Affiliation:
Prague Psychiatric Center, Ustavni 91, Prague 8, Bohnice, 181 03, Czech Republic The Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University, Ruska 87, Prague10, 100 00, Czech Republic
P. Stopkova
Affiliation:
Prague Psychiatric Center, Ustavni 91, Prague 8, Bohnice, 181 03, Czech Republic The Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University, Ruska 87, Prague10, 100 00, Czech Republic
J. Kozeny
Affiliation:
Prague Psychiatric Center, Ustavni 91, Prague 8, Bohnice, 181 03, Czech Republic The Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University, Ruska 87, Prague10, 100 00, Czech Republic
C. Höschl
Affiliation:
Prague Psychiatric Center, Ustavni 91, Prague 8, Bohnice, 181 03, Czech Republic The Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University, Ruska 87, Prague10, 100 00, Czech Republic
*
*Corresponding author. Tel.: +42 02 66 00 33 30; fax: +42 02 66 00 33 37. E-mail address:[email protected]
Get access

Abstract

Introduction

Current studies suggest that improvement of depressive symptoms after 2 weeks of treatment could predict the subsequent response. The aim of our study was to compare the predictive effect of early improvement (EI) after 1 and 2 weeks of treatment in patients who had failed to respond to previous antidepressant treatments (≥1 unsuccessful antidepressant trial).

Method

Seventy-one subjects were treated (≥4 weeks) with various antidepressants chosen according to the judgment of attending psychiatrists. We used three definitions of EI (MADRS reduction ≥20, 25, 30%) at both time points. Areas under curve (AUC) were calculated to compare predictive effect of EI.

Results

We found lower MADRS scores in weeks 1 and 2 in responders (≥50% reduction of MADRS, n = 35) compared to nonresponders. AUCs of MADRS reduction for response prediction at week 1 and 2 were not significantly different (0.73 vs 0.8; p = 0.24).

Conclusion

The results indicate that improvement of depressive symptoms in the treatment of resistant patients may occur after the first week of treatment. The predictive potential might be comparable to that found after the second week of antidepressant intervention and be clinically meaningful.

Keywords

Resistant depressionTreatmentAntidepressantsEarly improvementResponse prediction
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 7 , October 2012 , pp. 522 - 527
Copyright
Copyright © European Psychiatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association Diagnostic and statistical manual of mental disorders. 4th ed.Washington DC: American Psychiatric Press; 1994.Google Scholar
Anderson, I.M.Ferrier, I.N.Baldwin, R.C.Cowen, P.J.Howard, L.Lewis, G.et al.Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2000 British Association for Psychopharmacology guidelines. J Psychopharmacol. 2008; 22: 343–396.CrossRefGoogle ScholarPubMed
Bares, M.Brunovsky, M.Kopecek, M.Stopkova, P.Novak, T.Kozeny, J.et al.Changes in QEEG prefrontal cordance as a predictor of response to antidepressants in patients with treatment resistant depressive disorder: a pilot study. J Psychiatr Res. 2007; 41: 319–325.CrossRefGoogle ScholarPubMed
Bares, M.Brunovsky, M.Novak, T.Kopecek, M.Stopkova, P.Sos, P.et al.The change of prefrontal QEEG theta cordance as a predictor of response to bupropion treatment in patients who had failed to respond to previous antidepressant treatments. Eur Neuropsychopharmacol. 2010; 20: 459–466.CrossRefGoogle ScholarPubMed
Bauer, M.Bschor, T.Pfennig, A.Whybrow, P.C.Angst, J.Versiani, M.et al.World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders in Primary Care. World J Biol Psychiatry. 2007; 8: 67–104.CrossRefGoogle ScholarPubMed
Bech, P.Measurements issues.DHaenen, H.A.H.den Boer, J.A.Willner, P.Textbook of biological psychiatry. ChichesterJohn Wiley & Sons 2002 25–36.CrossRefGoogle Scholar
Bech, P.Tanghoj, P.Andersen, H.F.Overo, K.Citalopram dose-response revisited using an alternative psychometric approach to evaluate clinical effects of four fixed citalopram doses compared to placebo in patients with major depression. Psychopharmacology (Berl). 2002; 163: 20–25.CrossRefGoogle ScholarPubMed
Berman, R.M.Fava, M.Thase, M.E.Trivedi, M.H.Swanink, R.McQuade, R.D.et al.Aripiprazole augmentation in major depressive disorder: a double-blind, placebo-controlled study in patients with inadequate response to antidepressants. CNS Spectr. 2009; 14: 197–206.CrossRefGoogle Scholar
Bruder, G.E.Sedoruk, J.P.Stewart, J.W.McGrath, P.J.Quitkin, F.M.Tenke, C.E.Electroencephalographic alpha measures predict therapeutic response to a selective serotonin reuptake inhibitor antidepressant: pre- and post-treatment findings. Biol Psychiatry. 2008; 63: 1171–1177.CrossRefGoogle ScholarPubMed
Calker, D.Zobel, I.Dykierek, P.Deimel, C.M.Kech, S.Lieb, K.et al.Time course of response to antidepressants: predictive value of early improvement and effect of additional psychotherapy. J Affect Disord. 2009; 114: 243–253.CrossRefGoogle ScholarPubMed
Carmody, T.J.Rush, A.J.Bernstein, I.Warden, D.Brannan, S.Burnham, D.et al.The Montgomery Asberg and the Hamilton ratings of depression: a comparison of measures. Eur Neuropsychopharmacol. 2006; 16: 601–611.CrossRefGoogle ScholarPubMed
DeLong, E.R.DeLong, D.M.Clarke-Pearson, D.L.Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988; 44: 837–845.CrossRefGoogle ScholarPubMed
Fawcett, T.An introduction to ROC analysis. Pattern Recogn Lett. 2006; 27: 861–874.CrossRefGoogle Scholar
Garriock, H.A.Kraft, J.B.Shyn, S.I.Peters, E.J.Yokoyama, J.S.Jenkins, G.D.et al.A genomewide association study of citalopram response in major depressive disorder. Biol Psychiatry. 2010; 67: 133–138.CrossRefGoogle ScholarPubMed
Gorwood, P.Weiller, E.Lemming, O.Katona, C.Escitalopram prevents relapse in older patients with major depressive disorder. Am J Geriatr Psychiatry. 2007; 15: 581–593.CrossRefGoogle ScholarPubMed
Guy, W.ECDU assessment manual for psychopharmacology-revised. US Dept. Health Education and Welfare Publication. Rockville, MD(ADM) 76-338 1976 p. 218–22.Google Scholar
Hamilton, M.A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960; 23: 56–62.CrossRefGoogle ScholarPubMed
Henkel, V.Seemuller, F.Obermeier, M.Adli, M.Bauer, M.Mundt, C.et al.Does early improvement triggered by antidepressants predict response/remission? Analysis of data from a naturalistic study on a large sample of inpatients with major depression. J Affect Disord. 2009; 115: 439–449.CrossRefGoogle Scholar
Hennings, J.M.Owashi, T.Binder, E.B.Horstmann, S.Menke, A.Kloiber, S.et al.Clinical characteristics and treatment outcome in a representative sample of depressed inpatients - findings from the Munich Antidepressant Response Signature (MARS) project. J Psychiatr Res. 2009; 43: 215–229.CrossRefGoogle Scholar
Heo, M.Murphy, C.F.Meyers, B.S.Relationship between the Hamilton Depression Rating Scale and the Montgomery-Asberg Depression Rating Scale in depressed elderly: a meta-analysis. Am J Geriatr Psychiatry. 2007; 15: 899–905.CrossRefGoogle ScholarPubMed
Iosifescu, D.V.Greenwald, S.Devlin, P.Mischoulon, D.Denninger, J.W.Alpert, J.E.et al.Frontal EEG predictors of treatment outcome in major depressive disorder. Eur Neuropsychopharmacol. 2009; 19: 772–777.CrossRefGoogle ScholarPubMed
Kobak, K.A.Greist, J.H.Jefferson, J.W.Katzelnick, D.J.Computer-administered clinical rating scales. A review. Psychopharmacology (Berl). 1996; 127: 291–301.CrossRefGoogle ScholarPubMed
Lam, R.W.Kennedy, S.H.Grigoriadis, S.McIntyre, R.S.Milev, R.Ramasubbu, R.et al.Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. III. Pharmacotherapy. J Affect Disord. 117 Suppl1 2009 S26–S43.CrossRefGoogle ScholarPubMed
Leuchter, A.F.Cook, I.A.Marangell, L.B.Gilmer, W.S.Burgoyne, K.S.Howland, R.H.et al.Comparative effectiveness of biomarkers and clinical indicators for predicting outcomes of SSRI treatment in Major Depressive Disorder: results of the BRITE-MD study. Psychiatry Res. 2009; 169: 124–131.CrossRefGoogle ScholarPubMed
Little, J.T.Ketter, T.A.Kimbrell, T.A.Dunn, R.T.Benson, B.E.Willis, M.W.et al.Bupropion and venlafaxine responders differ in pretreatment regional cerebral metabolism in unipolar depression. Biol Psychiatry. 2005; 57: 220–228.CrossRefGoogle ScholarPubMed
Mayberg, H.S.Brannan, S.K.Mahurin, R.K.Jerabek, P.A.Brickman, J.S.Tekell, J.L.et al.Cingulate function in depression: a potential predictor of treatment response. Neuroreport. 1997; 8: 1057–1061.CrossRefGoogle Scholar
Montgomery, S.A.Asberg, M.A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979; 134: 382–389.CrossRefGoogle ScholarPubMed
Montgomery, S.A.Huusom, A.K.Bothmer, J.A randomised study comparing escitalopram with venlafaxine XR in primary care patients with major depressive disorder. Neuropsychobiology. 2004; 50: 57–64.CrossRefGoogle ScholarPubMed
Nakajima, S.Suzuki, T.Watanabe, K.Kashima, H.Uchida, H.Accelerating response to antidepressant treatment in depression: a review and clinical suggestions. Prog Neuropsychopharmacol Biol Psychiatry. 2010; 34: 259–264.CrossRefGoogle ScholarPubMed
Nierenberg, A.A.Farabaugh, A.H.Alpert, J.E.Gordon, J.Worthington, J.J.Rosenbaum, J.F.et al.Timing of onset of antidepressant response with fluoxetine treatment. Am J Psychiatry. 2000; 157: 1423–1428.CrossRefGoogle ScholarPubMed
Nierenberg, A.A.McLean, N.E.Alpert, J.E.Worthington, J.J.Rosenbaum, J.F.Fava, M.Early nonresponse to fluoxetine as a predictor of poor 8-week outcome. Am J Psychiatry. 1995; 152: 1500–1503.Google ScholarPubMed
Papakostas, G.I.Perlis, R.H.Scalia, M.J.Petersen, T.J.Fava, M.A meta-analysis of early sustained response rates between antidepressants and placebo for the treatment of major depressive disorder. J Clin Psychopharmacol. 2006; 26: 56–60.CrossRefGoogle ScholarPubMed
Posternak, M.A.Zimmerman, M.Is there a delay in the antidepressant effect? A meta-analysis. J Clin Psychiatry. 2005; 66: 148–158.CrossRefGoogle Scholar
Quitkin, F.M.McGrath, P.J.Stewart, J.W.Taylor, B.P.Klein, D.F.Can the effects of antidepressants be observed in the first two weeks of treatment?. Neuropsychopharmacology. 1996; 15: 390–394.CrossRefGoogle ScholarPubMed
Quitkin, F.M.Stewart, J.W.McGrath, P.J.Nunes, E.Ocepek-Welikson, K.Tricamo, E.et al.Further evidence that a placebo response to antidepressants can be identified. Am J Psychiatry. 1993; 150: 566–570.Google ScholarPubMed
Rush, A.J.Kraemer, H.C.Sackeim, H.A.Fava, M.Trivedi, M.H.Frank, E.et al.Report by the ACNP Task Force on response and remission in major depressive disorder. Neuropsychopharmacology. 2006; 31: 1841–1853.CrossRefGoogle ScholarPubMed
Rush, A.J.Trivedi, M.H.Wisniewski, S.R.Nierenberg, A.A.Stewart, J.W.Warden, D.et al.Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006; 163: 1905–1917.CrossRefGoogle ScholarPubMed
Santen, G.Danhof, M.Pasqua, O.D.Sensitivity of the Montgomery Asberg Depression Rating Scale to response and its consequences for the assessment of efficacy. J Psychiatr Res. 2009; 43: 1049–1056.CrossRefGoogle Scholar
Sheehan, D.V.Lecrubier, Y.Sheehan, K.H.Amorim, P.Janavs, J.Weiller, E.et al.The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998; 59 suppl. 20: 22–33.Google ScholarPubMed
Simon, G.E.Khandker, R.K.Ichikawa, L.Operskalski, B.H.Recovery from depression predicts lower health services costs. J Clin Psychiatry. 2006; 67: 1226–1231.CrossRefGoogle ScholarPubMed
Souery, D.Amsterdam, J.de Montigny, C.Lecrubier, Y.Montgomery, S.Lipp, O.et al.Treatment resistant depression: methodological overview and operational criteria. Eur Neuropsychopharmacol. 1999; 9: 83–91.CrossRefGoogle ScholarPubMed
Stassen, H.H.Angst, J.Hell, D.Scharfetter, C.Szegedi, A.Is there a common resilience mechanism underlying antidepressant drug response? Evidence from 2848 patients. J Clin Psychiatry. 2007; 68: 1195–1205.CrossRefGoogle Scholar
Stassen, H.H.Angst, J.Delini-Stula, A.Delayed onset of action of antidepressant drugs? Survey of results of Zurich meta-analyses. Pharmacopsychiatry. 1996; 29: 87–96.CrossRefGoogle Scholar
Szegedi, A.Jansen, W.T.van Willigenburg, A.P.van der Meulen, E.Stassen, H.H.Thase, M.E.Early improvement in the first 2 weeks as a predictor of treatment outcome in patients with major depressive disorder: a meta-analysis including 6562 patients. J Clin Psychiatry. 2009; 70: 344–353.CrossRefGoogle ScholarPubMed
Szegedi, A.Muller, M.J.Anghelescu, I.Klawe, C.Kohnen, R.Benkert, O.Early improvement under mirtazapine and paroxetine predicts later stable response and remission with high sensitivity in patients with major depression. J Clin Psychiatry. 2003; 64: 413–420.CrossRefGoogle ScholarPubMed
Tadic, A.Gorbulev, S.Dahmen, N.Hiemke, C.Braus, D.F.Roschke, J.et al.Rationale and design of the randomised clinical trial comparing early medication change (EMC) strategy with treatment as usual (TAU) in patients with major depressive disorder-the EMC trial. Trials. 2010; 11: 21.CrossRefGoogle ScholarPubMed
Taylor, M.J.Freemantle, N.Geddes, J.R.Bhagwagar, Z.Early onset of selective serotonin reuptake inhibitor antidepressant action: systematic review and meta-analysis. Arch Gen Psychiatry. 2006; 63: 1217–1223.CrossRefGoogle ScholarPubMed
Thase, M.E.Rush, A.J.When at first you don’t succeed: sequential strategies for antidepressant nonresponders. J Clin Psychiatry. 1997; 58 suppl. 13: 23–29.Google ScholarPubMed
Tohen, M.Case, M.Trivedi, M.H.Thase, M.E.Burke, S.J.Durell, T.M.Olanzapine/fluoxetine combination in patients with treatment-resistant depression: rapid onset of therapeutic response and its predictive value for subsequent overall response in a pooled analysis of 5 studies. J Clin Psychiatry. 2010; 71: 451–462.CrossRefGoogle Scholar
Uher, R.Perroud, N.Mandy, Y.M.Hauser, J.Henigsberg, N.Maier, W.et al.Genome-wide pharmacogenetics of antidepressant response in the GENDEP project. Am J Psychiatry. 2010; 167: 555–564.CrossRefGoogle ScholarPubMed
Uhr, M.Tontsch, A.Namendorf, C.Ripke, S.Lucae, S.Ising, M.et al.Polymorphisms in the drug transporter gene ABCB1 predict antidepressant treatment response in depression. Neuron. 2008; 57: 203–209.CrossRefGoogle ScholarPubMed
Wilson, E.B.Probable inference, the law of succession, and statistical inference. J Am Stat Assoc. 1927; 22: 209–212.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.