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Previous studies of patients with unipolar depression have shown that early decreases of prefrontal quantitative EEG (QEEG) cordance in theta band can predict clinical response to various antidepressants. We now examined whether reduction of prefrontal cordance value after 1 week of venlafaxine treatment predicts clinical response to venlafaxine in non-responders to previous antidepressant treatments.
We analyzed 25 inpatients, who finished 4-week treatment with venlafaxine. EEG data were monitored at baseline and after 1 week of treatment. QEEG cordance was computed at 3 frontal electrodes in theta frequency band. Depressive symptoms were assessed using Montgomery-Åsberg Depression Rating Scale (MADRS).
Eleven of 12 responders (reduction of MADRS ≥50%) and only 5 of 13 non-responders decreased prefrontal QEEG cordance value after the first week of treatment. The decrease of prefrontal cordance after week 1 in responders was significant (p=0.03) and there was no change in nonresponders. Positive and negative predictive value of cordance reduction for response was 0.7 and 0.9, respectively.
The reduction of prefrontal theta QEEG cordance value after first week of treatment is a useful tool in the response prediction to venlafaxine.
This study was supported by a grant from Internal Grant Agency of Ministry of Health of Czech Republic No. NR/9330-3 and a grant of Ministry of Education of Czech Republic MSMT 1M0517.
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).
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.
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).
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.
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