Ethnic differences in antidepressant response: a prospective multi-site clinical trial.
BACKGROUND
Although depression is a highly prevalent condition that occurs in all ethnic groups, the influence of ethnicity on treatment response still remains unclear.


METHODS
A prospective 8-week, open-label clinical trial comparing the efficacy and side effects of citalopram (CIT) with dose escalation (20-60 mg/day) was performed in African-Americans and Caucasians with nonpsychotic major depression. The intent-to-treat sample consisted of 301 participants (169 African-Americans and 132 Caucasians).


RESULTS
Although African-Americans were more socially disadvantaged and had a more severe depression, outcomes between the groups were similar. Remission rates were approximately 50% in both groups and about 2/3 of participants met response criteria. Retention was greater than 75% in both groups, with no differences in dropout rate. There were no differences in the number of completers, number of visits made, final dose of CIT, or in side effect profiles.


CONCLUSIONS
These results confirm the growing body of evidence, including recent studies using measurement-based care, that patients from minority groups have outcomes that are similar to those of Caucasians. The provision of measurement-based care and encouragement of patient participation can reduce ethnic differences in response to treatment for depression.
Lesser
Ira M
IM
Department of Psychiatry, Harbor-UCLA Medical Center and the Los Angeles Biomedical Research Institute, Torrance, California, USA. Ilesser@dhs.lacounty.gov
Myers
Hector F
HF
Lin
Keh-Ming
KM
Bingham Mira
Consuelo
C
Joseph
Nataria T
NT
Olmos
Natasha T
NT
Schettino
Jonathan
J
Poland
Russell E
RE
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D044465:White People / Q000523:psychology*
D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram