Predictors of response to lithium augmentation in tricyclic antidepressant-resistant depression.
BACKGROUND
The efficacy of lithium augmentation in therapy-resistant depression has been shown in a series of well-designed, placebo-controlled studies. However, little is known about the predictors of a good response to this treatment strategy.


METHODS
We retrospectively examined the predictive value of 20 demographic, clinical, biochemical and endocrinological variables using a two-step logistic regression. Seventy-one in-patients with depression refractory to tricyclic antidepressants had received lithium augmentation as part of a standardised treatment protocol.


RESULTS
Within 4 weeks 37 patients (52%) responded to lithium augmentation. Five variables with predictive value were found. Responders were more severely depressed according to the Bech-Rafaelsen Melancholia Scale. The duration of their index episode was shorter. Triiodothyronine serum levels were lower and neuroleptic co-medication and co-diagnosis of personality disorder were less frequent.


CONCLUSIONS
This was an open, retrospective study.


CONCLUSIONS
Severity of depression is a predictor of response to lithium augmentation. This result conflicts with recent studies but is similar to results found in studies of other pharmacological antidepressant strategies.
Bschor
T
T
Department of Psychiatry, Freie Universität Berlin, Berlin, Germany. bschort@zedat.fu-berlin.de
Canata
B
B
Müller-Oerlinghausen
B
B
Bauer
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D005544:Forecasting; D006801:Humans; D008094:Lithium / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000929:Antidepressive Agents, Tricyclic; D018692:Antimanic Agents; D008094:Lithium