About half of the patients who respond to antidepressants improve as a result of the natural course of the illness or due to nonspecific or """"""""placebo"""""""" effects rather than pharmacologic effects. Since current practice dictates drug maintenance for all responders to antidepressants, much continuation/maintenance pharmacotherapy may be unnecessary. If """"""""placebo"""""""" responses to an active drug could be identified, unnecessary medication could be discontinued, decreasing morbidity and cost. Knowing that initial improvement is attributable to a """"""""placebo"""""""" effect would also permit more rational treatment of relapses during continuation treatment. Multiple studies have shown that the analysis of patterns of response to acute antidepressant treatment differentiate """"""""true"""""""" or pharmacologic responses from """"""""placebo"""""""" or nonspecific responses. Preliminary data presented in this proposal suggest that pattern analysis also distinguishes patients who require medication during continuation/maintenance from those who do not. In this study, the predictive value of acute response pattern will be tested prospectively using a placebo-controlled discontinuation design. Success in this would allow clinically useful recommendations for continuation treatment to be made based on the collection of relatively simple and easily acquired clinical data.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Unknown (R10)
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Treatment Assessment Review Committee (TA)
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New York State Psychiatric Institute
New York
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Mischoulon, David; Lamon-Fava, Stefania; Selhub, Jacob et al. (2012) Prevalence of MTHFR C677T and MS A2756G polymorphisms in major depressive disorder, and their impact on response to fluoxetine treatment. CNS Spectr 17:76-86
Bruder, Gerard E; Stewart, Jonathan W; Hellerstein, David et al. (2012) Abnormal functional brain asymmetry in depression: evidence of biologic commonality between major depression and dysthymia. Psychiatry Res 196:250-4
Posternak, Michael A; Baer, Lee; Nierenberg, Andrew A et al. (2011) Response rates to fluoxetine in subjects who initially show no improvement. J Clin Psychiatry 72:949-54
Farabaugh, Amy H; Bitran, Stella; Witte, Janet et al. (2010) Anxious depression and early changes in the HAMD-17 anxiety-somatization factor items and antidepressant treatment outcome. Int Clin Psychopharmacol 25:214-7
Bruder, Gerard E; Sedoruk, James P; Stewart, Jonathan W et al. (2008) Electroencephalographic alpha measures predict therapeutic response to a selective serotonin reuptake inhibitor antidepressant: pre- and post-treatment findings. Biol Psychiatry 63:1171-7
Simon, N M; McNamara, K; Chow, C W et al. (2008) A detailed examination of cytokine abnormalities in Major Depressive Disorder. Eur Neuropsychopharmacol 18:230-3
Quitkin, Frederic M; McGrath, Patrick J; Stewart, Jonathan W et al. (2005) Remission rates with 3 consecutive antidepressant trials: effectiveness for depressed outpatients. J Clin Psychiatry 66:670-6
Kraft, Jeffrey B; Slager, Susan L; McGrath, Patrick J et al. (2005) Sequence analysis of the serotonin transporter and associations with antidepressant response. Biol Psychiatry 58:374-81
Peters, E J; Slager, S L; McGrath, P J et al. (2004) Investigation of serotonin-related genes in antidepressant response. Mol Psychiatry 9:879-89
Bruder, Gerard E; Stewart, Jonathan W; McGrath, Patrick J et al. (2004) Dichotic listening tests of functional brain asymmetry predict response to fluoxetine in depressed women and men. Neuropsychopharmacology 29:1752-61

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