title: Treatment outcomes of depression: the pharmacogenomic research network antidepressant medication pharmacogenomic study.
abstract: BACKGROUND
  The effectiveness of selective serotonin reuptake inhibitors (SSRIs) in patients with major depressive disorder (MDD) is controversial.
  
  
  OBJECTIVE
  The clinical outcomes of subjects with nonpsychotic MDD were reported and compared with the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study outcomes to provide guidance on the effectiveness of SSRIs.
  
  
  METHODS
  Subjects were treated with citalopram/escitalopram for up to 8 weeks. Depression was measured using the Quick Inventory of Depressive Symptomatology-Clinician Rated (QIDS-C16) and the 17-item Hamilton Depression Rating Scale.
  
  
  RESULTS
  The group of subjects with at least 1 follow-up visit had a remission (QIDS-C16 ≤ 5) rate of 45.8% as well as a response (50% reduction in QIDS-C16) rate of 64.8%, and 79.9% achieved an improvement of 5 points or higher in QIDS-C16 score. The Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study subjects were more likely to achieve a response than STAR*D study subjects. After adjustment for demographic factors, the response rates were not significantly different. When reporting the adverse effect burden, 60.5% of the subjects reported no impairment, 31.7% reported a minimal-to-mild impairment, and 7.8% reported a moderate-to-severe burden at the 4-week visit.
  
  
  CONCLUSIONS
  Patients contemplating initiating an SSRI to treat their MDD can anticipate a high probability of symptom improvement (79.9%) with a low probability that their symptoms will become worse. Patients with lower baseline severity have a higher probability of achieving remission. The Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study replicates many findings of the first phase of the STAR*D study after controlling for the differences between the studies.
authors.affiliation: From the Departments of *Psychiatry and Psychology, and †Health Sciences Research, Mayo Clinic, Rochester, MN; ‡Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York Presbyterian-Allen Hospital, New York, NY; §US Department of Defense, Department of Behavioral Health, Heidelberg, Germany; ∥Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine University of Iowa Hospitals and Clinics, Iowa, IA; and Departments of ¶Information Technology, and #Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN.
authors.forename: David A
authors.initials: DA
authors.lastname: Mrazek
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Biernacka
authors.forename: Donald E
authors.initials: DE
authors.lastname: McAlpine
authors.forename: Joachim
authors.initials: J
authors.lastname: Benitez
authors.forename: Victor M
authors.initials: VM
authors.lastname: Karpyak
authors.forename: Mark D
authors.initials: MD
authors.lastname: Williams
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Hall-Flavin
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Netzel
authors.forename: Victoria
authors.initials: V
authors.lastname: Passov
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Rohland
authors.forename: Gen
authors.initials: G
authors.lastname: Shinozaki
authors.forename: Astrid A
authors.initials: AA
authors.lastname: Hoberg
authors.forename: Karen A
authors.initials: KA
authors.lastname: Snyder
authors.forename: Maureen S
authors.initials: MS
authors.lastname: Drews
authors.forename: Michelle K
authors.initials: MK
authors.lastname: Skime
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Sagen
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Schaid
authors.forename: Richard
authors.initials: R
authors.lastname: Weinshilboum
authors.forename: David J
authors.initials: DJ
authors.lastname: Katzelnick
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010597:Pharmacogenetics; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors
references.citation: JAMA. 2010 Jan 6;303(1):47-53
references.pmid: 20051569
references.citation: JAMA. 2010 Apr 28;303(16):1598; author reply 1599
references.pmid: 20424247
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2009 Apr 5;150B(3):341-51
references.pmid: 18618621
references.citation: Control Clin Trials. 2004 Feb;25(1):119-42
references.pmid: 15061154
references.citation: Pharmacogenet Genomics. 2011 Jan;21(1):1-9
references.pmid: 21192344
references.citation: Am J Psychiatry. 2006 Jan;163(1):28-40
references.pmid: 16390886
references.citation: PLoS Med. 2008 Feb;5(2):e45
references.pmid: 18303940
references.citation: Br J Psychiatry. 2009 Jan;194(1):1-3
references.pmid: 19118316
references.citation: Biol Psychiatry. 2003 Sep 1;54(5):573-83
references.pmid: 12946886
references.citation: J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62
references.pmid: 14399272
references.citation: Biol Psychiatry. 2006 Mar 15;59(6):493-501
references.pmid: 16199008
references.citation: J Psychiatr Res. 2004 May-Jun;38(3):241-8
references.pmid: 15003429
references.citation: J Psychiatr Pract. 2006 Mar;12(2):71-9
references.pmid: 16728903