Format

Send to

Choose Destination
J Clin Psychiatry. 2005 Jun;66(6):670-6.

Remission rates with 3 consecutive antidepressant trials: effectiveness for depressed outpatients.

Author information

1
Department of Therapeutics, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, USA.

Abstract

OBJECTIVE:

This effectiveness study assessed remission rates in patients who had the opportunity to receive up to 3 antidepressant trials if unresponsive.

METHOD:

One hundred seventy-one consecutive outpatients entered 1 of 3 studies for the treatment of major depressive disorder (DSM-IV criteria) from January 1999 through December 2001. This group primarily received fluoxetine as a first treatment in trials lasting 6 to 12 weeks (a small number received gepirone). If unimproved, patients received a second or third trial (primarily clinician's choice). A standard criterion to determine remission-a score of 7 or less on the 17-item Hamilton Rating Scale for Depression-was used. In order to contrast remission rates with first-generation antidepressants, patients' outcomes in a previously published study that compared placebo, phenelzine, and imipramine were also examined (N = 420).

RESULTS:

In an intent-to-treat analysis, 66% (113/171) of patients who were treated with second-generation antidepressants and 65% (275/420) of patients who were treated with first-generation antidepressants eventually achieved remission.

CONCLUSIONS:

Remission rates in the effectiveness study are approximately 20% higher than the rates usually cited, a result of our choice to examine outcome following 3 treatment trials. This choice is dictated by good clinical practice. The usual procedure when comparing treatment modalities is to assess outcome after a single anti-depressant trial. The cumulative high remission rates suggest antidepressants are effective and should encourage more patients to seek treatment and physicians to develop techniques to improve patient adherence.

PMID:
15960558
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Physicians Postgraduate Press, Inc.
Loading ...
Support Center