1. Early symptom non-improvement and aggravation are associated with the treatment response to SSRIs in MDD: a real-world study
- Author
-
Shenxun Shi, Xiao Zhu, Hao Yao, Yiyun Cai, Michael Halim, Hsinsung Yuan, Alice Halim, and Qiang Luo
- Subjects
First episode ,medicine.medical_specialty ,business.industry ,Serotonin reuptake inhibitor ,medicine.disease ,030227 psychiatry ,03 medical and health sciences ,0302 clinical medicine ,Rating scale ,Internal medicine ,medicine ,Outpatient clinic ,Anxiety ,Major depressive disorder ,Headaches ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Depression (differential diagnoses) - Abstract
Purpose Early improvement in major depressive disorder is defined as a reduction of ≥20% in the 17-item Hamilton Depression Rating Scale (HAM-D-17) score at the second week after initiation of treatment, predicting long-term treatment response. However, there remains no effective strategy for switching medications when a patient fails to reach early improvement at the second week. This study focused on the predictive value of early symptom changes in each item of the HAM-D-17 scale for treatment response to selective serotonin reuptake inhibitor (SSRI) monotherapy and to provide a reference for switching antidepressants to enhance early treatment efficacy. Patients and methods Our study was an observational, real-world study that enrolled 90 treatment-naive patients experiencing their first episode of major depressive disorder in the outpatient department of Huashan Hospital. Patients who did not achieve the threshold of early improvement in the second week after starting treatment were switched to alternative SSRI monotherapy. Patient follow-up occurred at 2, 4, 8, and 12 weeks after the initiation of treatment. We analyzed the relationship between the change in each symptom on the HAM-D-17 scale and treatment efficacy. Results Early improvement predicted the treatment response at 12 weeks (χ2=19.249, P 999.999); treatment-emergent headache and tremor were associated with treatment efficacy (t=-9.521, P
- Published
- 2019