Prediction of treatment response in major depression: integration of concepts.
BACKGROUND
Two promising approaches have been introduced for the prediction of treatment response in major depression: one concept is based on the activity in the rostral anterior cingulate cortex (rACC). Subjects with higher metabolic rates respond better to sleep deprivation or antidepressive medication. Another approach is the investigation of the loudness dependence of the auditory evoked potential (LDAEP). Here, a high LDAEP is supposed to reflect low central serotonergic activity. We present the first study comparing both approaches in the same group of patients.


METHODS
Patients with major depression (n=20) were investigated using both resting EEG and LDAEP before treatment with either citalopram or reboxetine.


RESULTS
We found significant differences between responders and non-responders in the rACC in the theta-frequency range (6.5-8 Hz, p<0.05). In the subgroup of patients, treated with citalopram we found higher LDAEP-values in responders versus non-responders (p<0.05) and a significant correlation between pre-treatment-LDAEP and improvement in the Hamilton score after treatment (r=0.71, p<0.05).


CONCLUSIONS
In combining both methods a prediction whether a patient with major depression might be at risk for non-response to a standard therapy as well as a suggestion for a pharmacological approach of choice seems to be possible.
Mulert
Christoph
C
Department of Psychiatry, LMU, Munich, Germany. cmulert@med.uni-muenchen.de
Juckel
Georg
G
Brunnmeier
Michael
M
Karch
Susanne
S
Leicht
Gregor
G
Mergl
Roland
R
Möller
Hans-Jürgen
HJ
Hegerl
Ulrich
U
Pogarell
Oliver
O
D000928:Antidepressive Agents / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D004569:Electroencephalography; D004867:Equipment Design; D005072:Evoked Potentials, Auditory / Q000502:physiology; D005260:Female; D006179:Gyrus Cinguli / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D009482:Neurophysiology / Q000295:instrumentation; D011446:Prospective Studies; D000077593:Reboxetine; D012892:Sleep Deprivation / Q000453:epidemiology*; D013826:Theta Rhythm
D000928:Antidepressive Agents; D009025:Morpholines; D015283:Citalopram; D000077593:Reboxetine