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Br J Psychiatry
 2018
DOI: 10.1192/bjp.2018.122
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Predicting antidepressant response by monitoring early improvement of individual symptoms of depression: individual patient data meta-analysis

Ymkje Anna de Vries
1
,
Annelieke M. Roest
2
,
Elisabeth H. Bos
3
et al.

Abstract: Examining individual symptoms adds little to the predictive ability of early improvement. Additionally, early non-improvement does not rule out response or remission, particularly after 12 rather than 6 weeks. Therefore, our findings suggest that routinely adapting pharmacological treatment because of limited early improvement would often be premature.Declaration of interestNone.

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Cited by 45 publications

(35 citation statements)
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“…This study both replicates and extends the methods and results of two of our previous studies in older adults with MDD treated with nortriptyline or paroxetine 4 10. In younger patients with MDD, some29 but not all studies22 have suggested that treatment non-response as early as week 2 can be used to predict treatment non-response. However, in our study of older patients with MDD, more than ne-third of non-responders at weeks 1 and 2 attained full response at the end of treatment, suggesting that making a treatment decision before week 4 may result in premature discontinuation of a potentially helpful treatment in too many patients.…”
Section: Discussionsupporting
confidence: 83%
“…However, in our study of older patients with MDD, more than ne-third of non-responders at weeks 1 and 2 attained full response at the end of treatment, suggesting that making a treatment decision before week 4 may result in premature discontinuation of a potentially helpful treatment in too many patients. The difference between our results and some studies in younger patients may also be because some of these studies predicted ultimate response to 6–8 weeks of treatment rather than after a full 12-week course 22. Both decision trees identified more specific subgroups of participants who are very unlikely to attain treatment response after 12 weeks and should be considered for a change in treatment after 4 weeks.…”
Section: Discussioncontrasting
confidence: 69%
See 1 more Smart Citation
Exaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). Method Participants (SAD n = 58; HC n = 16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task.
show abstract
“…This study both replicates and extends the methods and results of two of our previous studies in older adults with MDD treated with nortriptyline or paroxetine 4 10. In younger patients with MDD, some29 but not all studies22 have suggested that treatment non-response as early as week 2 can be used to predict treatment non-response. However, in our study of older patients with MDD, more than ne-third of non-responders at weeks 1 and 2 attained full response at the end of treatment, suggesting that making a treatment decision before week 4 may result in premature discontinuation of a potentially helpful treatment in too many patients.…”
Section: Discussionsupporting
confidence: 83%
“…However, in our study of older patients with MDD, more than ne-third of non-responders at weeks 1 and 2 attained full response at the end of treatment, suggesting that making a treatment decision before week 4 may result in premature discontinuation of a potentially helpful treatment in too many patients. The difference between our results and some studies in younger patients may also be because some of these studies predicted ultimate response to 6–8 weeks of treatment rather than after a full 12-week course 22. Both decision trees identified more specific subgroups of participants who are very unlikely to attain treatment response after 12 weeks and should be considered for a change in treatment after 4 weeks.…”
Section: Discussioncontrasting
confidence: 69%
Exaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). Method Participants (SAD n = 58; HC n = 16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task.
show abstract
“…For early response on overall depression we found AUCs of 0.69 regarding response and 0.60 concerning remission of depression. These values are within the ranges of values reported previously and slightly lower compared with EII in our study: response AUC, 0.70 and remission of depression AUC, 0.63 25,27,38 . In contrast to these AUC values, which do not promote the use of early response as a predictor in in clinical practice, the NPV of EII might potentially be more useful if replicated in other cohorts.…”
Section: Discussionsupporting
confidence: 82%
“…A number of reviews reported that early response on overall depression predicts a positive outcome to pharmacotherapy in non-psychotic MDD, although sensitivity and specificity are modest 24–27,48 . For early response on overall depression we found AUCs of 0.69 regarding response and 0.60 concerning remission of depression.…”
Section: Discussionmentioning
confidence: 62%
Exaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). Method Participants (SAD n = 58; HC n = 16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task.
show abstract
“…This was corroborated by numerous studies which also exhibited an improvement in symptoms of depression after treating with antidepressants. 36-38 It was found that a there was a significant difference between the ASEX and FSFI scores before and after treatment in this study. The areas of improvement included a correction in the sex drive, and physiologic and psychological arousal.…”
Section: Comparison Of Ham-d Asex and Fsfi Scores Before And After mentioning
confidence: 47%
Exaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). Method Participants (SAD n = 58; HC n = 16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task.
show abstract
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