scholarly journals Prediction of Antidepressant Treatment Outcome Using Event-Related Potential in Patients with Major Depressive Disorder

Diagnostics ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 276
Author(s):  
Hyun Seo Lee ◽  
Seung Yeon Baik ◽  
Yong-Wook Kim ◽  
Jeong-Youn Kim ◽  
Seung-Hwan Lee
Keyword(s):  
Major Depressive Disorder ◽  
Treatment Outcome ◽  
Depressive Disorder ◽  
Auditory Evoked Potentials ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Event Related Potential ◽  
Major Depressive ◽  
Good Treatment Response ◽  
Treatment Responsiveness

(1) Background: Prediction of treatment outcome has been one of the core objectives in clinical research of patients with major depressive disorder (MDD). This study explored the possibility of event-related potential (ERP) markers to predict antidepressant treatment outcomes among MDD patients; (2) Methods: Fifty-two patients with MDD were recruited and evaluated through Hamilton depression (HAM-D), Hamilton anxiety rating scale (HAM-A), and CORE. Patients underwent a battery of ERP measures including frontal alpha symmetry (FAA) in the low alpha band (8–10 Hz), mismatch negativity (MMN), and loudness-dependent auditory evoked potentials (LDAEP); (3) Results: During the eight weeks of study, 61% of patients achieved remission, and 77% showed successful treatment responsiveness. Patients with low FAA in F5/F6 demonstrated a significantly higher remission/response ratio and better treatment responsiveness (F (2.560, 117.755) = 3.84, p = 0.016) compared to patients with high FAA. In addition, greater FAA in F7/F8 EEG channels was significantly associated with greater melancholia scores (r = 0.34, p = 0.018). Other ERP markers lacked any significant effect; (4) Conclusions: Our results suggested low FAA (i.e., greater left frontal activity) could reflect a good treatment response in MDD patients. These findings support that FAA could be a promising index in understanding both MDD and melancholic subtype.

Dimensions of anxiety in Major depressive disorder and their use in predicting antidepressant treatment outcome: an iSPOT-D report

2019 ◽  
Vol 50 (6) ◽  
pp. 1032-1042 ◽  
Author(s):  
Taylor A. Braund ◽  
Donna M. Palmer ◽  
Leanne M. Williams ◽  
Anthony W. F. Harris
Keyword(s):  
Major Depressive Disorder ◽  
Treatment Outcome ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Antidepressant Treatment ◽  
Anxiety Symptoms ◽  
Major Depressive ◽  
Somatic Anxiety

AbstractBackgroundMajor depressive disorder (MDD) commonly co-occurs with clinically significant levels of anxiety. However, anxiety symptoms are varied and have been inconsistently associated with clinical, functional, and antidepressant treatment outcomes. We aimed to identify and characterise dimensions of anxiety in people with MDD and their use in predicting antidepressant treatment outcome.Method1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic, MDD were assessed at baseline on clinical features and cognitive/physiological functioning. Participants were then randomised to one of three commonly prescribed antidepressants and reassessed at 8 weeks regarding symptom change, as well as remission and response, on the 17-item Hamilton Rating Scale Depression (HRSD17) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16). Exploratory factor analysis was used on items from scales assessing anxiety symptoms, and resulting factors were assessed against clinical features and cognitive/physiological functioning. Factors were also assessed on their ability to predict treatment outcome.ResultsThree factors emerged relating to stress, cognitive anxiety, and somatic anxiety. All factors showed high internal consistency, minimal cross-loadings, and unique clinical and functional profiles. Furthermore, only higher somatic anxiety was associated with poorer QIDS-SR16 remission, even after adjusting for covariates and multiple comparisons.ConclusionsAnxiety symptoms in people with MDD can be separated onto distinct factors that differentially respond to treatment outcome. Furthermore, these factors do not align with subscales of established measures of anxiety. Future research should consider cognitive and somatic symptoms of anxiety separately when assessing anxiety in MDD and their use in predicting treatment outcome.

scholarly journals 180 Improvement of Sexual Function Observed During Treatment of Major Depressive Disorder with Adjunctive Pimavanserin

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 313-314
Author(s):  
Marlene P. Freeman ◽  
Maurizio Fava ◽  
Bryan Dirks ◽  
Manish K. Jha ◽  
Richard C. Shelton ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Sexual Function ◽  
Rating Scale ◽  
Sexual Interest ◽  
Massachusetts General Hospital ◽  
Antidepressant Treatment ◽  
Analysis Of Covariance ◽  
Inadequate Response ◽  
Major Depressive

Abstract:Study Objectives:Sexual dysfunction occurs in 40%-60% of patients with major depressive disorder (MDD), due to either the illness itself and/or the effects of antidepressant treatment. The phase-2 CLARITY trial recently demonstrated the efficacy of adjunctive pimavanserin (PIM) for MDD when added to ongoing selective serotonin or serotonin–norepinephrine reuptake inhibitor (SSRI/SNRI) treatment. No new safety observations were reported in this study. This post-hoc analysis examines the potential impact of PIM treatment on sexual function.Method:Study methodology has been presented previously (APA 2019). Adult male and female patients with moderate-to-severe MDD were randomized to PIM 34 mg/day (n=51) or placebo (PBO, n=152) added to ongoing SSRI/SNRI treatment. Massachusetts General Hospital–Sexual Functioning Inventory (MGH-SFI) and Hamilton Depression Rating Scale, 17-item version (HAMD-17) item 14 (sexual interest) scores were examined by analysis of covariance.Results:Adjunctive PIM resulted in significantly greater 5-week reduction (improvement) relative to SSRI/SNRI treatment plus placebo on mean MGH-SFI scores (difference –0.634, SE 0.167; P<0.001; effect size [ES], Cohen’s d 0.614). Similarly, PIM resulted in greater improvement compared with placebo on individual MGH-SFI items that applied to both males and females: Interest in Sex (P=0.006; ES=0.483), Ability to Get Sexually Aroused/Excited (P=0.001; ES=0.560), Ability to Achieve Orgasm (P<0.001; ES=0.609), Overall Sexual Satisfaction (P=0.003; ES=0.524). HAMD-17 item 14 scores were also significantly more reduced (improved) with PIM (P<0.001; ES=0.574).Conclusions:These results underscore the potential of adjunctive PIM for improving sexual function in patients with MDD and inadequate response to SSRIs/SNRIs. Potential benefits should be confirmed in further studies.Funding Acknowledgements:ACADIA Pharmaceuticals Inc.

Effectiveness of mirtazapine as add-on to paroxetine v. paroxetine or mirtazapine monotherapy in patients with major depressive disorder with early non-response to paroxetine: a two-phase, multicentre, randomized, double-blind clinical trial

2020 ◽  
pp. 1-9 ◽  
Author(s):  
Le Xiao ◽  
Xuequan Zhu ◽  
Amy Gillespie ◽  
Yuan Feng ◽  
Jingjing Zhou ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Additional Treatment ◽  
Combination Group ◽  
Open Label ◽  
Major Depressive ◽  
Double Blind ◽  
Early Improvement

Abstract Background This study aimed to examine the efficacy of combining paroxetine and mirtazapine v. switching to mirtazapine, for patients with major depressive disorder (MDD) who have had an insufficient response to SSRI monotherapy (paroxetine) after the first 2 weeks of treatment. Methods This double-blind, randomized, placebo-controlled, three-arm study recruited participants from five hospitals in China. Eligible participants were aged 18–60 years with MDD of at least moderate severity. Participants received paroxetine during a 2-week open-label phase and patients who had not achieved early improvement were randomized to paroxetine, mirtazapine or paroxetine combined with mirtazapine for 6 weeks. The primary outcome was improvement on the Hamilton Rating Scale for Depression 17-item (HAMD-17) scores 6 weeks after randomization. Results A total of 204 patients who showed early non-response to paroxetine monotherapy were randomly assigned to receive either mirtazapine and placebo (n = 68), paroxetine and placebo (n = 68) or mirtazapine and paroxetine (n = 68), with 164 patients completing the outcome assessment. At week 8, the least squares (LS) mean change of HAMD-17 scores did not significantly differ among the three groups, (12.98 points) in the mirtazapine group, (12.50 points) in the paroxetine group and (13.27 points) in the mirtazapine plus paroxetine combination group. Participants in the paroxetine monotherapy group were least likely to experience adverse effects. Conclusions After 8 weeks follow-up, paroxetine monotherapy, mirtazapine monotherapy and paroxetine/mirtazapine combination therapy were equally effective in non-improvers at 2 weeks. The results of this trial do not support a recommendation to routinely offer additional treatment or a switch in treatment strategies for MDD patients who do not show early improvement after 2 weeks of antidepressant treatment.

scholarly journals Early improvement of executive test performance during antidepressant treatment predicts treatment outcome in patients with Major Depressive Disorder

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0194574 ◽  
Author(s):  
Stefanie Wagner ◽  
Isabella Helmreich ◽  
Daniel Wollschläger ◽  
Konstantin Meyer ◽  
Sabine Kaaden ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Treatment Outcome ◽  
Depressive Disorder ◽  
Test Performance ◽  
Antidepressant Treatment ◽  
Major Depressive ◽  
Early Improvement

scholarly journals Remote Digital Measurement of Facial and Vocal Markers of Major Depressive Disorder Severity and Treatment Response: A Pilot Study

2021 ◽  
Vol 3 ◽  
Author(s):  
Anzar Abbas ◽  
Colin Sauder ◽  
Vijay Yadav ◽  
Vidya Koesmahargyo ◽  
Allison Aghjayan ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Response ◽  
Head Movement ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Digital Measurement ◽  
Major Depressive ◽  
Patient Responses

Objectives: Multiple machine learning-based visual and auditory digital markers have demonstrated associations between major depressive disorder (MDD) status and severity. The current study examines if such measurements can quantify response to antidepressant treatment (ADT) with selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine uptake inhibitors (SNRIs).Methods: Visual and auditory markers were acquired through an automated smartphone task that measures facial, vocal, and head movement characteristics across 4 weeks of treatment (with time points at baseline, 2 weeks, and 4 weeks) on ADT (n = 18). MDD diagnosis was confirmed using the Mini-International Neuropsychiatric Interview (MINI), and the Montgomery–Åsberg Depression Rating Scale (MADRS) was collected concordantly to assess changes in MDD severity.Results: Patient responses to ADT demonstrated clinically and statistically significant changes in the MADRS [F(2, 34) = 51.62, p &lt; 0.0001]. Additionally, patients demonstrated significant increases in multiple digital markers including facial expressivity, head movement, and amount of speech. Finally, patients demonstrated significantly decreased frequency of fear and anger facial expressions.Conclusion: Digital markers associated with MDD demonstrate validity as measures of treatment response.

Characterising anxiety in major depressive disorder and its use in predicting antidepressant treatment outcome: An iSPOT-D report

2019 ◽  
Vol 53 (8) ◽  
pp. 782-793 ◽  
Author(s):  
Taylor A Braund ◽  
Donna M Palmer ◽  
Leanne M Williams ◽  
Anthony WF Harris
Keyword(s):  
Major Depressive Disorder ◽  
Treatment Outcome ◽  
Depressive Disorder ◽  
Anxiety Disorders ◽  
Clinical Features ◽  
Antidepressant Treatment ◽  
Anxiety Symptoms ◽  
Poor Agreement ◽  
Major Depressive ◽  
Anxious Depression

Objective: Major depressive disorder commonly co-occurs with one or more anxiety disorders or with clinically significant levels of anxiety symptoms. Although evidence suggests that anxious forms of depression are prognostic of poorer antidepressant outcomes, there is no clear definition of anxious depression, and inferences about clinical outcomes are thus limited. Our objective was to compare and evaluate definitions of anxious depression and anxiety-related scales according to clinical and antidepressant outcome criteria. Method: A total of 1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic, major depressive disorder were assessed at baseline on clinical features. Participants were then randomised to one of three antidepressants and reassessed at 8 weeks regarding remission and response of the 17-item Hamilton Rating Scale Depression (HRSD17) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16). Anxious depression was defined as major depressive disorder with one or more anxiety disorders or major depressive disorder with a HRSD17 anxiety/somatisation factor score ⩾7. Anxiety-related scales included the HRSD17 anxiety/somatisation factor and the 42-item Depression Anxiety Stress Scales (DASS42) anxiety and stress subscales. Results: Anxious depression definitions showed poor agreement (κ = 0.15) and the HRSD17 anxiety/somatisation factor was weakly correlated with both DASS42 anxiety ( r = 0.24) and stress subscales ( r = 0.20). Anxious depression definitions were also associated with few impairments on clinical features and did not predict poorer antidepressant treatment outcome. However, higher DASS42 anxiety predicted poorer HRSD17 and QIDS-SR16 remission, and item-level analysis found higher scores on items 9 (situational anxiety) and 23 (somatic anxiety) of the DASS42 predicted poorer treatment outcome, even after adjusting for covariates and multiple comparisons. Conclusion: Common definitions of anxious depression show poor agreement and do not predict poorer treatment outcome. Anxiety symptoms may be better characterised dimensionally using DASS42 when predicting treatment outcome.

scholarly journals Effect of antidepressant switching between nortriptyline and escitalopram after a failed first antidepressant treatment among patients with major depressive disorder

2019 ◽  
Vol 215 (2) ◽  
pp. 494-501 ◽  
Author(s):  
Ole Köhler-Forsberg ◽  
Erik Roj Larsen ◽  
Henriette N. Buttenschøn ◽  
Marcella Rietschel ◽  
Joanna Hauser ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Side Effects ◽  
Depressive Disorder ◽  
Rating Scales ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Linear Regression Models ◽  
Major Depressive ◽  
Advisory Boards ◽  
The Government

BackgroundFor patients with major depressive disorder (MDD) experiencing side-effects or non-response to their first antidepressant, little is known regarding the effect of switching between a tricyclic antidepressant (TCA) and a selective serotonin reuptake inhibitor (SSRI).AimsTo compare the switch between the TCA nortriptyline and the SSRI escitalopram.MethodAmong 811 adults with MDD treated with nortriptyline or escitalopram for up to 12 weeks, 108 individuals switched from nortriptyline to escitalopram or vice versa because of side-effects or non-response (trial registration: EudraCT No.2004-001723-38 (https://eudract.ema.europa.eu/) and ISRCTN No.03693000 (http://www.controlled-trials.com)). Patients were followed for up to 26 weeks after switching and response was measured with the Montgomery–Åsberg Depression Rating scale (MADRS). We performed adjusted mixed-effects linear regression models with full information maximum likelihood estimation reporting β-coefficients with 95% CIs.ResultsSwitching antidepressants resulted in a significant decrease in MADRS scores. This was present for switchers from escitalopram to nortriptyline (n = 36, β = −0.38, 95% CI −0.51 to −0.25, P<0.001) and from nortriptyline to escitalopram (n = 72, β = −0.34, 95% CI −0.41 to −0.26, P<0.001). Both switching options resulted in significant improvement among individuals who switched because of non-response or side-effects. The results were supported by analyses on other rating scales and symptom dimensions.ConclusionsThese results suggest that switching from a TCA to an SSRI or vice versa after non-response or side-effects to the first antidepressant may be a viable approach to achieve response among patients with MDD.Declarations of interestK.J.A. holds an Alberta Centennial Addiction and Mental Health Research Chair, funded by the Government of Alberta. K.J.A. has been a member of various advisory boards, received consultancy fees and honoraria, and has received research grants from various companies including Johnson and Johnson Pharmaceuticals Research and Development and Bristol-Myers Squibb Pharmaceuticals Limited. D.S. has served on advisory boards for, and received unrestricted grants from, Lundbeck and AstraZeneca. A.F. and P.M. have received honoraria for participating in expert panels for Lundbeck and GlaxoSmithKline.

scholarly journals Remote digital measurement of visual and auditory markers of Major Depressive Disorder severity and treatment response.

2020 ◽  
Author(s):  
Isaac Galatzer-Levy ◽  
Anzar Abbas ◽  
Vijay Yadav ◽  
Vidya Koesmahargyo ◽  
Allison Aghjayan ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Response ◽  
Head Movement ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Digital Measurement ◽  
Major Depressive ◽  
Patient Responses

Objectives: Multiple machine learning-based visual and auditory digital markers have demonstrated associations between Major Depressive Disorder (MDD) status and severity. The current study examines if such measurements can quantify response to antidepressant treatment (ADT) with selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine uptake inhibitors (SNRIs). Methods: Visual and auditory markers were acquired through an automated smartphone task that measures facial, vocal, and head movement characteristics across the first five weeks of treatment (with timepoints at 1, 3, and 5 weeks) on ADT (n = 12). The Montgomery-Asberg Depression Rating Scale (MADRS) was collected concordantly through clinical interviews to confirm diagnosis and assess changes in MDD severity. Results: Patient responses to ADT demonstrated clinically and statistically significant changes in the MADRS F(2,34) = 51.62, p <.0001. Additionally, patients demonstrated significant increases in multiple digital markers including facial expressivity, head movement, and amount of speech. Finally, patients demonstrated significant decreased frequency of fear and anger facial expressions. Conclusion: Digital markers associated with MDD demonstrate validity as measures of treatment response.

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