Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-17T21:29:22.796Z Has data issue: false hasContentIssue false
  • English
  • Français

Early predictors of two month response with mianserin and selective serotonin reuptake inhibitors and influence of definition of outcome on prediction

Published online by Cambridge University Press:  16 April 2020

I Berlin  and
F Lavergne
I Berlin
Affiliation:
Department of Pharmacology, Hôpital Pitié-Salpêtrière, 47 Bd de l'Hôpital, 75013Paris
F Lavergne
Affiliation:
Department of Psychiatry, Organon France, Saint-Denis, France
Get access

Summary

In order to identify clinical and demographic variables that predict response to antidepressants and to analyse prediction of outcome as a function of definition of outcome we analysed pooled data of two independent, multicentre, double blind parallel group studies. Study I compared the efficacy of mianserin with that of fluoxetine in 65, and study II compared mianserin with fluvoxamine in 60 patients with depression. Improvement was defined as at least 20% decrease in MADRS by day 14. Patients were considered as responders if they had greater than 50% decrease and non-responders if they had ≤ 50% decrease from baseline in the MADRS at day 56. Complete remission was defined as MADRS score ≤ 6 at day 56. Patients' characteristics did not differ between mianserin and SSRI groups. Early improvement predicted response in 92% and complete remission in 55% of the patients improved at day 14. Multivariate forward stepwise logistic regression analysis showed that response to treatments at day 56 was significantly (P = 0.0003) associated with early improvement, age (responders had higher age than non-responders) and weight (responders weighted more than non-responders). Complete remission was only predicted by early improvement. Treatments could not be differentiated when data were analysed according to responder/nonresponder status or complete remission/no complete remission. However, when the same data were analysed by analysis of variance a significant treatment effect (P = 0.02, mianserin > SSRIs) and a quadratic type treatment by time interaction (P = 0.023) were found. The robustness of the analysis was further improved by inclusion of covariates (age, weight). Early clinical improvement seems to be the best predictor of 2 month response to antidepressants (mianserin, SSRIs). Younger age and lower weight may predict non-response. Quantitative analysis differentiates treatments better than analysis of responder status. As obtenation of complete remission is a realistic objective with current antidepressants, studies longer than 2 months are needed to assess effectiveness of these drugs in the obtenation of complete remission.

Keywords

antidepressanttreatment responsepredictors
Type
Research Article
Information
European Psychiatry , Volume 13 , Issue 3 , May 1998 , pp. 138 - 142
Copyright
Copyright © Elsevier, Paris 1998

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 Third edition. APA Stuttgart 1980Google Scholar
Hamilton, MThe assessment of anxiety by rating Br J Med Psychol 1959; 32: 50–55CrossRefGoogle ScholarPubMed
Ko, HC, Lu, RB, Shiah, IS, Hwang, CCPlasma free 3-methoxy-4-hydorxyphenylglycol predicts response to fluoxetine Biol Psychiatry 1997; 41: 774–781CrossRefGoogle ScholarPubMed
Maier, W, Philipp, M, Buller, R, Schlegel, SReliability and validity of the Newcastle Scale in relation to ICD-9 classification Acta Psychiatr Scand 1987; 76: 619–627CrossRefGoogle ScholarPubMed
Montgomery, SA, Asberg, MA new depression scale designed to be sensitive to change Br J Psychiatry 1979; 134: 382–389CrossRefGoogle ScholarPubMed
Nierenberg, AATreatment choice after one antidepressant fails: a survey of North-eastern psychiatrists J Clin Psychiatry 1991; 52: 383–385Google Scholar
Nierenberg, AA, McLean, NE, Alpert, JE, Worthington, JJ, Rosenbaum, JF, Fava, MEarly nonresponse to fluoxetine as a predictor of poor 8-week outcome Am J Psychiatry 1995; 152: 1500–1503Google ScholarPubMed
Radat, F, Berlin, I, Spreux-Varoquaux, O, Elatki, S, Ferreri, M, Puech, AJInitial monoamine oxidase-A inhibition by moclobemide does not predict the therapeutic response in patients with major depression Psychopharmacology 1996; 127: 370–376CrossRefGoogle Scholar
Snaith, RP, Harrop, FM, Newby, DA, Teale, CGrade scores of the Montgomery-Asberg Depression and the Clinical Anxiety Scales Br J Psychiatry 1986; 148: 599–601CrossRefGoogle ScholarPubMed
Stassen, HH, Angst, J, Delini-Stula, ADelayed onset of action of antidepressant drugs? Survey of results of Zurich meta-analyses Pharmacopsychiatr 1996; 29: 87–96CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.