The loudness dependency of the auditory evoked N1/P2-component as a predictor of the acute SSRI response in depression.
BACKGROUND
A serotonergic dysfunction is supposed to play a pathogenetic role in depression, but there is a considerable number of non-responders in the acute treatment of depression with serotonergic agents like SSRI. Thus, an indicator of central serotonergic activity could lead to a more specific pharmacological treatment of depression. In animal and human data there is a growing amount of evidence that a strong loudness dependency of late auditory evoked potentials (LDAEP) is an indicator of low serotonergic activity and vice versa.


OBJECTIVE
In 29 depressive inpatients (DSM-III-R diagnosis 296.x in 28 patients, 300.4 in one patient), the hypothesis was tested that a strong LDAEP prior to treatment can predict a better clinical outcome under SSRI treatment over 4 weeks.


RESULTS
Patients with a strong pre-treatment LDAEP had a significantly greater decrease of depressive symptoms (Hamilton Scale for Depression) after 4 weeks than patients with a flat LDAEP. Significantly more responders fell into the group with a high LDAEP. Contrary to what might be expected, a second recording in a subsample of 19 patients after 4 weeks of treatment failed to show changes in the LDAEP.


CONCLUSIONS
Our finding confirms the hypothesis that a strong LDAEP, indicating a low serotonergic activity, is related to a favorable response to acute SSRI treatment in depression. The LDAEP is a promising tool for the prediction of response to serotonin agonists in depression and it seems to be of clinical importance.
Department of Psychiatry, Free University Berlin, Germany. gallinat@zedat.fu-berlin.de
J
J
Gallinat
R
R
Bottlender
G
G
Juckel
A
A
Munke-Puchner
G
G
Stotz
H J
HJ
Kuss
P
P
Mavrogiorgou
U
U
Hegerl
D000161:Acoustic Stimulation; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005072:Evoked Potentials, Auditory / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013997:Time Factors
D017367:Selective Serotonin Reuptake Inhibitors