title: Sex differences in the prediction of the effectiveness of paroxetine for patients with major depressive disorder identified using a receiver operating characteristic curve analysis for early response.
abstract: BACKGROUND
  We investigated cutoff values for the early response of patients with major depressive disorder to paroxetine and their sex differences by using a receiver operating characteristic (ROC) curve analysis to predict the effectiveness of paroxetine.
  
  
  METHODS
  In total, 120 patients with major depressive disorder were enrolled and treated with 10-40 mg/day paroxetine for 6 weeks; 89 patients completed the protocol. A clinical evaluation using the Montgomery-Asberg Depression Rating Scale (MADRS) was performed at weeks 0, 1, 2, 4, and 6.
  
  
  RESULTS
  In male subjects, the cutoff values for MADRS improvement rating in week 1, week 2, and week 4 were 20.9%, 34.9%, and 33.3%, respectively. The sensitivities and the specificities were 83.3% and 80.0%, 83.3% and 80.0%, and 100% and 90%, respectively. The areas under the curve (AUC) were 0.908, 0.821, and 0.979, respectively. In female subjects, the cutoff values for the MADRS improvement rating in week 1, week 2, and week 4 were 21.4%, 35.7%, and 32.3%, respectively. The sensitivities and the specificities were 71.4% and 84.6%, 73.8% and 76.9%, and 90.5% and 76.9%, respectively. The AUCs were 0.781, 0.735, and 0.904, respectively.
  
  
  CONCLUSIONS
  Early improvement with paroxetine may predict the long-term response. The accuracy of the prediction for the response is higher in male subjects.
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Tomita
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Yasui-Furukori
authors.forename: Yasui-Furukori
authors.initials: YF
authors.lastname: Norio
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Nakagami
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Tsuchimine
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kaneda
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Sunao
authors.initials: S
authors.lastname: Kaneko
keywords: antidepressants; early response; paroxetine; receiver operating characteristic curve analysis; sex differences
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