TRH stimulation test as a predictor of acute and long-term antidepressant response in major depression.
We assessed the prognostic utility of the TRH stimulation test by examining (a) the relationship between pre-treatment delta TSH and acute response to fluoxetine treatment, and (b) the relationship between the change in delta TSH (delta delta TSH value) after repeated TRH testing at 6 weeks of fluoxetine treatment and long-term outcome during maintenance fluoxetine or placebo therapy. 43 MDD patients were studied with sequential TRH tests at 6-week intervals. Fluoxetine 'responders' were defined as patients with a Hamilton Depression Rating Scale score < or = 7 by week 9 of treatment and who remained in remission at least 3 additional weeks. These subjects were then randomized to one of four fluoxetine/placebo treatment groups and long-term outcome assessed. Overall, there was no difference in the mean pre-treatment delta TSH values between acute fluoxetine responders and nonresponders. Moreover, we observed similar delta delta TSH values in patients who maintained long-term remission compared to those who relapsed during maintenance with either fluoxetine or placebo. In contrast to prior reports of an higher delta delta TSH value in long-term remitters, the present observation of similar mean delta delta TSH values patients with long-term remission compared to those who relapsed suggest a limited prognostic utility for the TRH stimulation test in MDD.
Amsterdam
J D
JD
Depression Research Unit, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
Fava
M
M
Maislin
G
G
Rosenbaum
J
J
Hornig-Rohan
M
M
D000328:Adult; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011863:Radioimmunoassay; D012463:Saliva / Q000737:chemistry; D013972:Thyrotropin / Q000032:analysis / Q000378:metabolism*; D013973:Thyrotropin-Releasing Hormone / Q000378:metabolism*
D010919:Placebos; D005473:Fluoxetine; D013973:Thyrotropin-Releasing Hormone; D013972:Thyrotropin