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Neurocognitive predictors of antidepressant clinical response
- Source :
- Journal of Affective Disorders. 166:108-114
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- Background Executive dysfunction and psychomotor slowing in depressed patients have been associated with poor antidepressant clinical response, but little is known about the value of neurocognitive tests for differential prediction of response. Methods This report presents new findings for 70 depressed patients tested on neurocogntive tests before receiving treatment with a SSRI (escitalopram or citalopram), NDRI (bupropion) or dual mechanism therapy including a serotonergic agent, and for 57 healthy controls. Results As predicted from previous research, patients who did not respond to a SSRI or dual therapy showed poorer word fluency than responders, whereas this was not seen for patients treated with bupropion alone. Longer choice reaction time (RT) was also found in nonresponders to a SSRI or dual therapy, but the opposite trend was seen for bupropion. Using a combined index of word fluency and RT (with normative performance as a cutoff) yielded differential predictions of response. Equal to or above normal performance predicted good response to a SSRI or dual therapy, with high positive predictive value (90%) and specificity (78%) but lower sensitivity (53%). In contrast, less than normal performance predicted good response to bupropion alone (positive predictive value=82%; specificity=67%; sensitivity=90%). Limitations Relatively small sample size, no placebo control, and combining across SSRI alone and dual treatments. Conclusions Although findings are preliminary due to small sample size, brief tests of word fluency and psychomotor speed may help identify depressed patients who are unresponsive to a serotonergic agent, but who may respond to bupropion alone.
- Subjects :
- Adult
Male
Oncology
medicine.medical_specialty
Citalopram
Placebo
Article
Double-Blind Method
Internal medicine
mental disorders
medicine
Humans
Escitalopram
Bupropion
Psychomotor learning
Depressive Disorder
Middle Aged
Psychiatry and Mental health
Clinical Psychology
Treatment Outcome
Case-Control Studies
Antidepressive Agents, Second-Generation
Antidepressant
Female
Psychology
Neurocognitive
Selective Serotonin Reuptake Inhibitors
medicine.drug
Clinical psychology
Executive dysfunction
Subjects
Details
- ISSN :
- 01650327
- Volume :
- 166
- Database :
- OpenAIRE
- Journal :
- Journal of Affective Disorders
- Accession number :
- edsair.doi.dedup.....e0d9696bf4e1f73684a8d747ff4899f5