title: Does prior antidepressant treatment of major depression impact brain function during current treatment?
abstract: The relationship between prior antidepressant treatment and prefrontal brain functional response to subsequent treatment with antidepressant medication or placebo is unknown. Eighty-nine adults with Major Depressive Disorder (MDD), characterized as antidepressant-experienced or antidepressant-naive, received one week of single-blind placebo treatment prior to eight weeks of randomized treatment with medication (fluoxetine or venlafaxine; n = 47) or placebo (n = 42) in one of three similar placebo-controlled trials. Brain function was assessed at baseline, end of placebo lead-in, and during randomized treatment using quantitative electroencephalography (qEEG). The authors assessed change in prefrontal theta-band cordance (PFC) in antidepressant-experienced vs. antidepressant-naive subjects. Treatment history groups differed significantly on PFC change during the placebo lead-in even when controlling for clinical and demographic variables (F(1,62) = 4.27, p = .04). As assessed in linear mixed models that examined treatment history (antidepressant-experienced or antidepressant-naive), treatment assignment (medication or placebo), and their interaction as predictors, treatment history also predicted PFC change during the randomized phase of treatment even when controlling for pretreatment clinical and demographic and symptom improvement during treatment (F(1,5o) = 5.20, p = .03). The interaction was not significant. Post hoc analyses showed that antidepressant-experienced subjects treated with placebo showed PFC changes that did not differ from PFC changes seen in the medication group. Results suggest that prefrontal brain functional changes during treatment for MDD may differ depending upon prior treatment with antidepressant medication.
authors.affiliation: Laboratory of Brain, Behavior, and Pharmacology, and the Depression Research and Clinic Program, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA 90024-1759, United States. amhunger@ucla.edu
authors.forename: Aimee M
authors.initials: AM
authors.lastname: Hunter
authors.forename: Ian A
authors.initials: IA
authors.lastname: Cook
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Leuchter
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D003511:Cyclohexanols / Q000009:adverse effects / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000187:drug effects*; D017397:Prefrontal Cortex / Q000187:drug effects* / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D016037:Single-Blind Method; D013826:Theta Rhythm / Q000187:drug effects*; D000069470:Venlafaxine Hydrochloride
chemical_list: D000928:Antidepressive Agents; D003511:Cyclohexanols; D005473:Fluoxetine; D000069470:Venlafaxine Hydrochloride