Pretreatment frontal EEG and changes in suicidal ideation during SSRI treatment in major depressive disorder.
OBJECTIVE
We investigated frontal quantitative EEG (QEEG) as predictor of changes in suicidal ideation (SI) during SSRI treatment in major depressive disorder (MDD).


METHODS
Eighty-two subjects meeting DSM-IV criteria for MDD entered an 8-week, prospective, open-label treatment with flexible dose SSRIs and completed at least 4 weeks of treatment. We assessed MDD severity with the 17-item Hamilton Depression Rating Scale (HAM-D-17); change in SI was measured with HAM-D item no. 3. We recorded four-channel EEGs (F7-Fpz, F8-Fpz, A1-Fpz, A2-Fpz) before treatment.


RESULTS
During the first 4 weeks of treatment 9 (11%) subjects experienced worsening SI. Left-right asymmetry of combined theta + alpha power correlated significantly with change in SI from baseline, even when adjusting for changes in depression severity (HAM-D-17) and for the SSRI utilized.


CONCLUSIONS
Frontal QEEG parameters before treatment may predict worsening SI during SSRI treatment in MDD.
Iosifescu
D V
DV
Depression Clinical and Research Program, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA. diosifescu@partners.org
Greenwald
S
S
Devlin
P
P
Perlis
R H
RH
Denninger
J W
JW
Alpert
J E
JE
Fava
M
M
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D007839:Functional Laterality / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
D017367:Selective Serotonin Reuptake Inhibitors