Treatment outcomes of depression: The pharmacogenomic research network antidepressant medication pharmacogenomic study

David A. Mrazek, Joanna M. Biernacka, Donald E. McAlpine, Joachim Benitez, Victor M. Karpyak, Mark D. Williams, Daniel K. Hall-Flavin, Pamela J. Netzel, Victoria Passov, Barbara M. Rohland, Gen Shinozaki, Astrid A. Hoberg, Karen A. Snyder, Maureen S. Drews, Michelle K. Skime, Jessica A. Sagen, Daniel J. Schaid, Richard Weinshilboum, David J. Katzelnick

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

BACKGROUND: The effectiveness of selective serotonin reuptake inhibitors (SSRIs) in patients with major depressive disorder (MDD) is controversial. AIMS: The clinical outcomes of subjects with nonpsychotic MDD were reported and compared with the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study outcomes to provide guidance on the effectiveness of SSRIs. METHODS: Subjects were treated with citalopram/escitalopram for up to 8 weeks. Depression was measured using the Quick Inventory of Depressive Symptomatology - Clinician Rated (QIDS-C16) and the 17-item Hamilton Depression Rating Scale. RESULTS: The group of subjects with at least 1 follow-up visit had a remission (QIDS-C16 ≤ 5) rate of 45.8% as well as a response (50% reduction in QIDS-C16) rate of 64.8%, and 79.9% achieved an improvement of 5 points or higher in QIDS-C16 score. The Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study subjects were more likely to achieve a response than STAR*D study subjects. After adjustment for demographic factors, the response rates were not significantly different. When reporting the adverse effect burden, 60.5% of the subjects reported no impairment, 31.7% reported a minimal-to-mild impairment, and 7.8% reported a moderate-to-severe burden at the 4-week visit. CONCLUSIONS: Patients contemplating initiating an SSRI to treat their MDD can anticipate a high probability of symptom improvement (79.9%) with a low probability that their symptoms will become worse. Patients with lower baseline severity have a higher probability of achieving remission. The Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study replicates many findings of the first phase of the STAR*D study after controlling for the differences between the studies.

Original languageEnglish (US)
Pages (from-to)313-317
Number of pages5
JournalJournal of Clinical Psychopharmacology
Volume34
Issue number3
DOIs
StatePublished - Jun 2014

Keywords

  • antidepressants
  • depression
  • mood disorders
  • pharmacotherapy
  • treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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    Mrazek, D. A., Biernacka, J. M., McAlpine, D. E., Benitez, J., Karpyak, V. M., Williams, M. D., Hall-Flavin, D. K., Netzel, P. J., Passov, V., Rohland, B. M., Shinozaki, G., Hoberg, A. A., Snyder, K. A., Drews, M. S., Skime, M. K., Sagen, J. A., Schaid, D. J., Weinshilboum, R., & Katzelnick, D. J. (2014). Treatment outcomes of depression: The pharmacogenomic research network antidepressant medication pharmacogenomic study. Journal of Clinical Psychopharmacology, 34(3), 313-317. https://doi.org/10.1097/JCP.0000000000000099