title: Tachyphylaxis after repeated antidepressant drug exposure in patients with recurrent major depressive disorder.
abstract: OBJECTIVE
  The aim of this post hoc analysis was to examine whether tachyphylaxis occurs after repeated courses of antidepressant drug therapy.
  
  
  METHODS
  276 patients with major depressive disorder (MDD) were treated with sertraline (150-200 mg daily) for 8 weeks. Patients with persistent MDD after sertraline therapy were randomized to continuation therapy with either sertraline plus atomoxetine (n = 72) or sertraline plus placebo (n = 74) for 8 additional weeks. Logistic regression was used to test the hypothesis that an increase in prior antidepressant drug exposure is associated with a reduced responsiveness to sertraline therapy.
  
  
  RESULTS
  The number of prior antidepressant drug exposures was negatively associated with response to initial sertraline therapy (odds ratio = 0.81, p = 0.0035). The odds ratio indicates a 19.9% reduced likelihood of response with each prior antidepressant treatment trial. In contrast, the number of prior antidepressant treatment trials was not associated with response to continuation sertraline plus atomoxetine or sertraline plus placebo therapy.
  
  
  CONCLUSIONS
  This observation supports the hypothesis that tachyphylaxis may develop after repeated antidepressant drug trials.
authors: Depression Research Unit, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-3309, USA. jamsterd@mail.med.upenn.edu
authors: Jay D
authors: JD
authors: Amsterdam
authors: David
authors: D
authors: Williams
authors: David
authors: D
authors: Michelson
authors: Lenard A
authors: LA
authors: Adler
authors: David L
authors: DL
authors: Dunner
authors: Andrew A
authors: AA
authors: Nierenberg
authors: Frederick W
authors: FW
authors: Reimherr
authors: Alan F
authors: AF
authors: Schatzberg
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011437:Propylamines / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D020280:Sertraline / Q000008:administration & dosage / Q000627:therapeutic use*; D013618:Tachyphylaxis; D016896:Treatment Outcome
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride; D020280:Sertraline