Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T06:54:38.808Z Has data issue: false hasContentIssue false
  • English
  • Français

Initial response to active drug and placebo predicts outcome of antidepressant treatment

Published online by Cambridge University Press:  16 April 2020

S Priebe  and
M Bröker
S Priebe
Affiliation:
Department of Social Psychiatry, Freie Universität Berlin, Platanenallee 19, 14050Berlin, Germany
M Bröker
Affiliation:
Department of Social Psychiatry, Freie Universität Berlin, Platanenallee 19, 14050Berlin, Germany
Get access

Summary

In this study we tested whether initial clinical change (ICC) and initial subjective response (ISR) predict the outcome of antidepressant pharmacotherapy and whether ICC and ISR as predictors reflect specific pharmacological actions or a placebo effect. Forty patients with major depression were treated with three different antidepressants for 4 weeks. Overall clinical change and final subjective response were taken as outcome criteria. The patients were randomly assigned to two subgroups in a double-blind design. Initially, one group received the active drug and the other placebo. Afterwards, all patients were given the active drug. Significant correlations were found between ICC and ISR and at least one of the outcome criteria in the total sample and in each subgroup. The findings show that ICC and ISR may be significant predictors of outcome. The predictive value of ICC and ISR is not due to initial pharmacological effects, but to non-specific treatment factors.

Keywords

initial responseantidepressantspredictionoutcomedepression
Type
Original article
Information
European Psychiatry , Volume 12 , Issue 1 , 1997 , pp. 28 - 33
Copyright
Copyright © Elsevier, Paris 1997

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 3rd edn Revised Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association, 1987Google Scholar
Bartkó, G, Herczeg, I, Békésy, M. Predicting outcome of neuroleptic treatment on the basis of subjective response and early clinical improvement. J Clin Psychiatry 1987; 48: 363–365Google ScholarPubMed
Bielski, RJ, Friedel, RO. Prediction of tricyclic antidepressant response: A critical review. Arch Gen Psychiatry 1976; 33: 1479–1489CrossRefGoogle ScholarPubMed
Brody, HPlacebos and the Philosophy of Medicine. Chicago: The University of Chicago Press, 1980Google Scholar
Bröker, M, Röhricht, F, Priebe, S. Initial assessment of hospital treatment by patients with paranoid schizophrenia: A predictor of outcome. Psychiat Res 1995; 58: 77–81CrossRefGoogle ScholarPubMed
Coryell, W, Coppen, A, Zeigler, VE, Biggs, JT. Early improvement as a predictor of response to amitriptyline and nortriptyline: a comparison of 2 patient samples. Psychol Med 1982; 12: 135–139CrossRefGoogle ScholarPubMed
Fink, EB, Braden, W, Qualls, CB. Predicting pharmacotherapy outcome by subjective response. J Clin Psychiatry 1982; 43: 272–275Google ScholarPubMed
Goodwin, FK. Predictors of antidepressant response. Bull Menninger Clin 1993; 57: 146–160Google ScholarPubMed
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56–62CrossRefGoogle ScholarPubMed
Joyce, CRBNon-specific aspects of treatment from the point of view of a clinical pharmacologist. In: Shepherd, M, Sartorius, N eds. Non-Specific Aspects of Treatment. Toronto: Huber, 1989; 57–94Google Scholar
Joyce, PR, Paykel, ES. Predictors of drug response in depression. Arch Gen Psychiatry 1989; 46: 89–99CrossRefGoogle ScholarPubMed
Katz, MM, Koslow, SH, Maas, JW, et al.The timing, specificity and clinical prediction of tricyclic drug effects in depression Psychol Med 17 1987 297–309CrossRefGoogle ScholarPubMed
Klerman, GL, Cole, JO. Clinical pharmacology of imipramine and related antidepressant compounds. Pharmacol Rev 1965; 17: 101–141Google ScholarPubMed
Kocsis, JH. New issues in the prediction of antidepressant response. Psychopharmacol Bull 1990; 16: 49–53Google Scholar
May, PRA, Goldberg, SCPrediction of schizophrenic patient's response to pharmacotherapy. In: Lipton, MA, DiMascio, A, Killam, KF eds. Psychopharmacology: A Generation of Progress. New York: Raven, 1978; 1139–1153Google Scholar
May, PRA, Van Putten, T, Yale, C, et al.Predicting individual responses to drug treatment in schizophrenia: A test dose model J Nerv Ment Dis 162 1976 177–183CrossRefGoogle ScholarPubMed
May, PRA, Van Putten, T, Yale, C. Predicting outcome of antipsychotic drug treatment from early response. Am J Psychiatry 1980; 137: 1088–1089Google ScholarPubMed
May, PRA, Van Putten, T, Jenden, DJ, Yale, C, Dixon, WJ, Goldstein, MJ. Prognosis in schizophrenia: Individual differences in psychological response to a test dose of antipsychotic drug and their relationship to blood and saliva levels and treatment outcome. Compr Psychiatry 1981; 22: 147–152CrossRefGoogle ScholarPubMed
Morris, JB, Beck, AT. The efficacy of antidepressant drugs. A review of research (1958–1972). Arch Gen Psychiatry 1974; 30: 667–674CrossRefGoogle ScholarPubMed
Nagayama, H, Nagano, K, Ikezaki, A, Tashiro, T. Prediction of efficacy of antidepressant by 1-week test therapy in depression. J Affect Dis 1991; 23: 213–216CrossRefGoogle ScholarPubMed
Nedopil, N, Rüther, E. Initial improvement as predictor of outcome of neuroleptic treatment. Pharmacopsychiat 1981; 14: 205–207CrossRefGoogle ScholarPubMed
Nedopil, N, Pflieger, R, Rüther, E. The prediction of acute response, remission and general outcome of neuroleptic treatment in acute schizophrenic patients. Pharmacopsychiat 1983; 16: 201–205CrossRefGoogle ScholarPubMed
Priebe, S. Early subjective reactions predicting the outcome of hospital treatment in depressive patients. Acta Psychiatr Scand 1987; 76: 134–138CrossRefGoogle ScholarPubMed
Priebe, SDie Bedeutung der Patientenmeinung. Initiale Bewertung und Verlauf psychiatrischer Therapie. Göttingen: Hogrefe, 1992Google Scholar
Priebe, S, Gruyters, T. Patients' and caregivers' initial assessments of day hospital treatment and course of symptoms. Compr Psychiatry 1994; 35: 234–238CrossRefGoogle ScholarPubMed
Priebe, S, Gruyters, T. The importance of the first three days: Predictors of treatment outcome in depressed in-patients. Br J Clin Psychol 1995; 34: 229–236CrossRefGoogle ScholarPubMed
Rickels, KNon-specific factors in drug therapy of neurotic patientsRickels, KNon-Specific Factors in Drug Therapy Springfield: Thomas, 1968; 3–26Google Scholar
Rothschild, R, Quitkin, FM. Review of the use of pattern analysis to differentiate true drug and placebo responses. Psychother Psychosom 1992; 58: 170–177CrossRefGoogle ScholarPubMed
Singh, MM. Dysphoric response to neuroleptic treatment in schizophrenia and its prognostic significance. Dis Nerv Syst 1976; 37: 191–196Google ScholarPubMed
Singh, MM, Kay, SR. Dysphoric response to neuroleptic treatment in schizophrenia: Its relationship to autonomic arousal and prognosis. Biol Psychiatry 1979; 14: 277–294Google ScholarPubMed
Singh, MM, Smith, JM. Kinetics and dynamics of response to haloperidol in acute schizophrenia — a longitudinal study of the therapeutic process. Compr Psychiatry 1973; 14: 393–414CrossRefGoogle ScholarPubMed
Van Putten, T, May, PRA. Subjective response as a predictor of outcome in pharmacotherapy. Arch Gen Psychiatry 1978; 35: 477–480CrossRefGoogle ScholarPubMed
Van Putten, T, May, PRA, Jenden, DJ, Cho, AK, Jale, C. Plasma and saliva levels of chlorpromazine and subjective response. Am J Psychiatry 1980; 137: 1241–1242Google ScholarPubMed
Van Putten, T, May, PRA, Marder, SR. Subjective responses to thiotixene and chlorpromazine. Psychopharmacol Bull 1980; 16: 36–38Google Scholar
Van Putten, T, May, PRA, Marder, SR, Wittmann, LA. Subjective response to antipsychotic drugs. Arch Gen Psychiatry 1981; 38: 187–190CrossRefGoogle ScholarPubMed
Woggon, B, Baumann, U. Multimethodological approach in psychiatric predictor research. Pharmacopsychiat 1983; 16: 175–178CrossRefGoogle ScholarPubMed
Woggon, BUnsolved problems in the pharmacotherapy of depressionCasey, DE, Christensen, AVPsychopharmacology: Current Trends Psychopharmacology Series 5 Berlin: Springer, 1988; 159–165CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.