Predicting antidepressant treatment outcome based on socioeconomic status and citalopram dose

Viglione, Aurelia; Chiarotti, Flavia; Poggini, S.; Giuliani, Alessandro; Branchi, Igor

doi:10.1038/s41397-019-0080-6

Cited by 33 publications

(26 citation statements)

References 33 publications

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“…Our results are consistent with previous findings that greater number of medication failures in the current episode is an important negative predictor of remission after rTMS. The influence of socioeconomic status has been investigated in the outcomes after treatment with citalopram using data from the STAR*D with higher remission rates associated with working employment status [30,31]. In the current study, we included working status as potential clinical predictor variable (self-employed, part-time employed, and full-time employed as currently working versus unemployed or retired, as not currently working), not only as a measure of baseline functionality, but also because working status has been shown to be a positive predictor of achieving remission with other treatments.…”

Section: Discussionmentioning

confidence: 99%

Predictors of remission after repetitive transcranial magnetic stimulation for the treatment of major depressive disorder: An analysis from the randomised non-inferiority THREE-D trial

et al. 2020

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Background: Although repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD), treatment selection is still mainly a process of trial-and-error. The present study aimed to identify clinical predictors of remission after a course of rTMS delivered to the left DLPFC to improve patient selection. Methods: Data from a large randomised non-inferiority trial comparing standard 10 Hz and intermittent theta burst stimulation (iTBS) for the treatment of MDD were used for the exploratory analyses. Individual variables were assessed for their association with remission and then included in a logistic regression model to determine odds ratios (OR) and corresponding 95% confidence intervals. Model discrimination (internal validation) was carried out to assess model optimism using the c-index. ClinicalTrials.gov identifier: NCT01887782. Findings: 388 subjects were included in the analysis (199-iTBS and 189-10 Hz, respectively). Higher baseline severity of both depressive and anxiety symptoms were associated with a lower chance of achieving remission (OR=0.64, 95% CI 0.46À0.88; and 0.78, 95% CI 0¢60À0.98, respectively). Current employment was a positive predictor for remission (OR=1.69, 95% CI 1.06À2.7), while greater number of treatment failures was associated with lower odds of achieving remission (OR=0.51, 95% CI 0.27À0.98). A non-linear effect of age and remission was observed. An analysis to allow an estimate of the probability of remission using all variables was assessed. The c-index for the fitted model was 0.687. Interpretation: Our results suggest that measuring depression symptom severity, employment status, and refractoriness are important in prognosticating outcome to a course of rTMS in MDD.

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Section: Discussionmentioning

confidence: 99%

Predictors of remission after repetitive transcranial magnetic stimulation for the treatment of major depressive disorder: An analysis from the randomised non-inferiority THREE-D trial

et al. 2020

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“…Lower SES has been established to be linked to lower levels of mental well-being [11,17]. However, the limited previous research has only explored the effects of SES on either the utilisation or outcomes of one form of treatmenteither medication [18] or psychological therapy [19][20][21]. In a large British Household survey, Jokela and colleagues [21] found that higher SES was linked to being less likely to have mental health issues and to access public psychotherapy services, but instead more likely to access private services.…”

Section: Discussionmentioning

confidence: 99%

Do people living in disadvantaged circumstances receive different mental health treatments than those from less disadvantaged backgrounds?

et al. 2020

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Background: Socioeconomic status (SES) has been linked to treatment outcomes for mental health problems, whilst little to no literature has explored the effects of SES on access to both medication and psychological therapy. The aim of this study was to explore whether access to mental health treatments differed by SES. Methods: The North West Coast Household Health Survey (HHS) collected data from residents aged 18+ from across 20 disadvantaged and 8 less disadvantaged neighbourhoods in 2015, and from 20 disadvantaged neighbourhoods in 2018. Logistic regression was used to explore the effects of SES on access to treatment (medication, psychological therapy) for people who had experienced mental health problems in the past 12 months. Results: Of 6860 participants, 2932 reported experiencing mental health problems in the past 12 months. People from more disadvantaged backgrounds experienced greater rates of anxiety and depression. Anti-depressant and anti-psychotic medication treatment was significantly more common in residents with lower SES, as well as counselling. Regression analysis showed that residents from more disadvantaged neighbourhoods who reported mental distress were more likely to receive medication. Conclusions: This appears to be the first study showing higher levels of treatment with medication and psychological therapy in people from disadvantaged backgrounds. Future research needs to address the underlying factors associated with increased mental health treatment uptake in people from lower socioeconomic backgrounds.

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“…6,7 ET has serious side effects such as nausea, dry mouth, sleep disturbance, constipation, fatigue, drowsiness, and dizziness, resulting in patients needing to gradually increase the therapeutic dose. 6,7 ET has serious side effects such as nausea, dry mouth, sleep disturbance, constipation, fatigue, drowsiness, and dizziness, resulting in patients needing to gradually increase the therapeutic dose.…”

Section: Introductionmentioning

confidence: 99%

“…Here, we used escitalopram (ET), an antidepressant, which is a selective serotonin reuptake inhibitor in the brain cells . ET has serious side effects such as nausea, dry mouth, sleep disturbance, constipation, fatigue, drowsiness, and dizziness, resulting in patients needing to gradually increase the therapeutic dose .…”

Section: Introductionmentioning

confidence: 99%

PLGA Microsphere Addition to 1‐Hydroxy‐2‐napthoic Acid Enhances the Sustained Release of Escitalopram

Kang

Kim

Kwon

et al. 2019

Bulletin Korean Chem Soc

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Escitalopram (ET), a selective serotonin reuptake inhibitor, has been utilized for the treatment of depression and anxiety. However, ET has serious side effects such as nausea, leading to an increased therapeutic dose, needing multiple administrations. Therefore, to overcome these issues, we developed ET encapsulated poly (d,l-lactic-co-glycolic acid) (PLGA) microspheres (PLGA-MS) as a sustained release carrier to maintain therapeutic efficacy. The mean particle size of the PLGA-MSs was measured by microscopy. Loading efficiency was measured by high performance liquid chromatography (HPLC). Morphologies were determined by microscopy and scanning electron microscopy (SEM). Differential scanning calorimetry (DSC) was used for thermal analysis and glass transition temperature determination. Mean particle size of the ET-loaded PLGA-MSs was 129 AE 14 μm, loading efficiency was 36.8 AE 9.1%, and encapsulation efficiency was up to 70.6 AE 6.8%. Loading efficiency and encapsulation efficiency were increased by the addition of 1-hydroxy-2-naphthoic acid (HNA). ET was released from PLGA-MS for 4 weeks, which was longer than ET release from PLGA-MS without the addition of HNA. Taken together, we demonstrate the optimum condition for sustained release of ET from PLGA-MS with the addition of HNA, and that this approach may be useful for depression therapy.

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Predicting antidepressant treatment outcome based on socioeconomic status and citalopram dose

Cited by 33 publications

References 33 publications

Predictors of remission after repetitive transcranial magnetic stimulation for the treatment of major depressive disorder: An analysis from the randomised non-inferiority THREE-D trial

Predictors of remission after repetitive transcranial magnetic stimulation for the treatment of major depressive disorder: An analysis from the randomised non-inferiority THREE-D trial

Do people living in disadvantaged circumstances receive different mental health treatments than those from less disadvantaged backgrounds?

PLGA Microsphere Addition to 1‐Hydroxy‐2‐napthoic Acid Enhances the Sustained Release of Escitalopram

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