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Severity of depressive symptoms and response to antidepressants and placebo in antidepressant trials.
J Psychiatr Res 2005; 39(2):145-50JP

Abstract

Although increased pre-treatment severity of depressive symptoms is thought to suggest better outcome with tricyclic antidepressants, it is unclear if such a pattern exists among those depressed patients treated with newer antidepressants. If such a pattern with newer antidepressants were observed, it would have implications for the design and conduct of future antidepressant trials. We reviewed the data from 329 depressed adult patients that were part of 15 multi-center, randomized, double blind, placebo-controlled antidepressant clinical trials at our center. Based on patients' pre-treatment scores on the 17-item Hamilton Depression Rating Scale (HAM-D), patients were sub-grouped to one of four severity of depression groups: low moderate, high moderate, moderately severe, and severe. The effect size was 0.51 in the low moderate group, 0.54 in the high moderate group, 0.77 in the moderately severe group and 1.09 in the severe group. An analysis of variance revealed a statistically significant interaction between treatment and severity of depressive symptoms. A correlational analysis revealed that in the group of depressed patients assigned to antidepressants, higher levels of pre-treatment depressive symptoms were significantly associated with greater changes in response to antidepressant treatment. Although a similar pattern was seen among the depressed patients assigned to placebo, it did not reach statistical significance. The results of this study suggest that antidepressant-placebo differences may be larger among those depressed outpatients with higher pre-treatment HAM-D scores compared to those depressed outpatients with lower pre-treatment scores. These findings may help in the design of future antidepressant clinical trials.

Authors+Show Affiliations

Northwest Clinical Research Center, Bellevue, MA, USA. akhan@nwcrc.netNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

15589562

Citation

Khan, Arif, et al. "Severity of Depressive Symptoms and Response to Antidepressants and Placebo in Antidepressant Trials." Journal of Psychiatric Research, vol. 39, no. 2, 2005, pp. 145-50.
Khan A, Brodhead AE, Kolts RL, et al. Severity of depressive symptoms and response to antidepressants and placebo in antidepressant trials. J Psychiatr Res. 2005;39(2):145-50.
Khan, A., Brodhead, A. E., Kolts, R. L., & Brown, W. A. (2005). Severity of depressive symptoms and response to antidepressants and placebo in antidepressant trials. Journal of Psychiatric Research, 39(2), pp. 145-50.
Khan A, et al. Severity of Depressive Symptoms and Response to Antidepressants and Placebo in Antidepressant Trials. J Psychiatr Res. 2005;39(2):145-50. PubMed PMID: 15589562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severity of depressive symptoms and response to antidepressants and placebo in antidepressant trials. AU - Khan,Arif, AU - Brodhead,Amy E, AU - Kolts,Russell L, AU - Brown,Walter A, PY - 2004/04/20/received PY - 2004/06/07/revised PY - 2004/06/28/accepted PY - 2004/12/14/pubmed PY - 2005/4/27/medline PY - 2004/12/14/entrez SP - 145 EP - 50 JF - Journal of psychiatric research JO - J Psychiatr Res VL - 39 IS - 2 N2 - Although increased pre-treatment severity of depressive symptoms is thought to suggest better outcome with tricyclic antidepressants, it is unclear if such a pattern exists among those depressed patients treated with newer antidepressants. If such a pattern with newer antidepressants were observed, it would have implications for the design and conduct of future antidepressant trials. We reviewed the data from 329 depressed adult patients that were part of 15 multi-center, randomized, double blind, placebo-controlled antidepressant clinical trials at our center. Based on patients' pre-treatment scores on the 17-item Hamilton Depression Rating Scale (HAM-D), patients were sub-grouped to one of four severity of depression groups: low moderate, high moderate, moderately severe, and severe. The effect size was 0.51 in the low moderate group, 0.54 in the high moderate group, 0.77 in the moderately severe group and 1.09 in the severe group. An analysis of variance revealed a statistically significant interaction between treatment and severity of depressive symptoms. A correlational analysis revealed that in the group of depressed patients assigned to antidepressants, higher levels of pre-treatment depressive symptoms were significantly associated with greater changes in response to antidepressant treatment. Although a similar pattern was seen among the depressed patients assigned to placebo, it did not reach statistical significance. The results of this study suggest that antidepressant-placebo differences may be larger among those depressed outpatients with higher pre-treatment HAM-D scores compared to those depressed outpatients with lower pre-treatment scores. These findings may help in the design of future antidepressant clinical trials. SN - 0022-3956 UR - https://www.unboundmedicine.com/medline/citation/15589562/Severity_of_depressive_symptoms_and_response_to_antidepressants_and_placebo_in_antidepressant_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3956(04)00082-2 DB - PRIME DP - Unbound Medicine ER -