title: A pilot study of actigraphy as an objective measure of SSRI activation symptoms: results from a randomized placebo controlled psychopharmacological treatment study.
abstract: Selective serotonin reuptake inhibitors (SSRIs) are an efficacious and effective treatment for pediatric obsessive-compulsive disorder (OCD) but have received scrutiny due to a potential side effect constellation called activation syndrome. While recent research introduced a subjective measure of activation syndrome, objective measures have not been tested. This pilot study, using data from a larger randomized-controlled trial, investigated the potential of actigraphy to provide an objective measure of activation symptoms in 44 youths with OCD beginning an SSRI medication regimen. Data were collected over the first four weeks of a multi-site, parallel, double-blind, randomized, placebo controlled psychopharmacological treatment study and statistical modeling was utilized to test how activation syndrome severity predicts daily and nightly activity levels. Results indicated that youths with higher activation symptoms had lower daytime activity levels when treatment averages were analyzed; in contrast youths who experienced onset of activation symptoms one week were more likely to have higher day-time and night-time activity ratings that week. Results support actigraphy as a potential objective measure of activation symptoms. Subsequent studies are needed to confirm these findings and test clinical applications for use by clinicians to monitor activation syndrome during SSRI treatment. National Institutes of Health (5UO1 MH078594-01); NCT00382291.
authors.affiliation: Department of Psychiatry, University of Florida, Gainesville, FL, United States; Department of Pediatrics, University of Florida, Gainesville, FL, United States; Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, United States.
authors.forename: Regina
authors.initials: R
authors.lastname: Bussing
authors.affiliation: Department of Psychiatry, University of Florida, Gainesville, FL, United States; Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, United States. Electronic address: reidam@phhp.ufl.edu.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Reid
authors.affiliation: Department of Psychiatry, University of Florida, Gainesville, FL, United States.
authors.forename: Joseph P H
authors.initials: JP
authors.lastname: McNamara
authors.affiliation: Department of Psychology, University of Wyoming, Laramie, WY, United States.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Meyer
authors.affiliation: Department of Psychiatry, University of Florida, Gainesville, FL, United States; Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, United States.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Guzick
authors.affiliation: Department of Psychiatry, University of Florida, Gainesville, FL, United States.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Mason
authors.affiliation: Department of Pediatrics, University of South Florida, St. Petersburg, FL, United States; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL, United States.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
authors.affiliation: Department of Pediatrics, University of South Florida, St. Petersburg, FL, United States; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL, United States.
authors.forename: Tanya K
authors.initials: TK
authors.lastname: Murphy
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D002648:Child; D002940:Circadian Rhythm / Q000187:drug effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D010865:Pilot Projects; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D013577:Syndrome; D016896:Treatment Outcome; D014481:United States
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: Activation syndrome; Children; Obsessive-compulsive disorder; Randomized-controlled trial; Selective serotonin reuptake inhibitors; Treatment