Brain functional changes (QEEG cordance) and worsening suicidal ideation and mood symptoms during antidepressant treatment.
OBJECTIVE
Antidepressant medications are efficacious overall; however, some individuals experience worsening mood symptoms and increased suicidal ideation (SI) during treatment. We examined the quantitative electroencephalographic (QEEG) cordance biomarker of brain function biomarker in relation to treatment-emergent symptom worsening.


METHODS
Seventy-two major depressive disorder (MDD) subjects were treated with fluoxetine 20 mg (n = 13), venlafaxine 150 mg (n = 24), or placebo (n = 35) under double-blind conditions. Behavioral ratings determined whether each subject demonstrated worsening of depressed mood, anxiety, or SI during treatment. QEEG cordance data were analyzed to determine whether symptom worsening was associated with neurophysiological changes.


RESULTS
Antidepressant treatment-emergent SI (13.5%) was associated with a large transient decrease in midline-and-right-frontal (MRF) cordance 48 h after start of medication.


CONCLUSIONS
Hypothesis-generating results suggest a pattern of functional changes in midline and right frontal brain regions associated with antidepressant treatment-emergent SI in MDD.
Hunter
A M
AM
Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA 90024-1759, USA. amhunter@ucla.edu
Leuchter
A F
AF
Cook
I A
IA
Abrams
M
M
D000328:Adult; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects*; D002140:California / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D003511:Cyclohexanols / Q000009:adverse effects / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D004311:Double-Blind Method; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D000069470:Venlafaxine Hydrochloride
D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D005473:Fluoxetine; D000069470:Venlafaxine Hydrochloride