Prediction of clinical response to antidepressants in patients with depression: neurophysiology in clinical practice.
Brain monoaminergic neurotransmission is involved in the pathophysiology of various psychiatric disorders including depression. Reliable indicators of central monoaminergic activity might be helpful to specifically identify and differentiate dysfunctions in individual patients in order to selectively adjust medication and predict clinical response. In patients with depression, predictors of treatment response to serotonergic versus non-serotonergic (e.g., noradrenergic) antidepressants could be of considerable clinical relevance by avoiding unfavorable factors such as a prolonged duration of the disorder, risk of suicidality and therapy-resistance. Consequently, these tools might help to decrease direct and indirect costs of treatment. The loudness dependence of the N1/P2 component of auditory evoked potentials (LD) has been proposed as a noninvasive neurophysiological indicator of central serotonergic function. This review focuses on recent studies providing evidence for the validity of LD as an indirect serotonergic marker and highlights data on the clinical application in terms of prediction of treatment response in patients with depression.
Pogarell
Oliver
O
Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany. oliver.pogarell@med.uni-muenchen.de
Juckel
Georg
G
Norra
Christine
C
Leicht
Gregor
G
Karch
Susanne
S
Schaaff
Nadine
N
Folkerts
Malte
M
Ibrahim
Ahmad
A
Mulert
Christoph
C
Hegerl
Ulrich
U
D000161:Acoustic Stimulation / Q000379:methods; D000928:Antidepressive Agents / Q000008:administration & dosage*; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy*; D004569:Electroencephalography / Q000187:drug effects* / Q000379:methods*; D005072:Evoked Potentials, Auditory / Q000187:drug effects*; D006801:Humans; D009482:Neurophysiology / Q000379:methods; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000639:trends; D011379:Prognosis; D016896:Treatment Outcome
D000928:Antidepressive Agents