Prediction of remission of depression with clinical variables, neuropsychological performance, and serotonergic/dopaminergic gene polymorphisms

Abstract

Our results suggest that clinical and neuropsychological variables can initially predict early response to fluoxetine and mask the predictive role of genetic variables; but in remission, where clinical and neuropsychological symptoms associated with depression tend to disappear thanks to the treatment administered, the polymorphisms studied are the only variables in our model capable of predicting remission. However, placebo effects that are difficult to control require cautious interpretation of the results.

A Systematic Review of Cognitive Predictors of Treatment Outcome in Major Depression

“…In two samples (14, 20), slower psychomotor speed was associated with poorer response to treatment (total n = 254). In contrast, three samples showed no association between SSRI treatment and psychomotor speed ( n = 320) (13, 17, 20). In the large study by Etkin et al slower psychomotor speed was associated with non-remission to Escitalopram, but not to Sertraline (20).…”

“…Six shorter studies (total n = 204) (13, 14, 17, 19, 22, 23) and one longer-term study ( n = 91) (25) found no relationship between non-verbal learning and memory, and treatment response. One study ( n = 26) found that poorer non-verbal memory performance was associated with better response to a combined dopamine and noradrenaline re-uptake inhibitor (26).…”

“…They found that impairment in attention and working memory was associated with non-remission on Escitalopram; however, this relationship was not seen with Sertraline (20). Of the negative studies, Gudayol- Ferré et al found no evidence of an association between executive function or attention and overall response to Fluoxetine (17); however, they did find an association with early treatment response and time to remission (16, 18). In their sample of 72 depressed patients, poorer attention and spatial working memory were associated with poorer response at 4 weeks, but the opposite relationship was seen with “subsequent thinking time” on the Stockings of Cambridge (16).…”

“…Seven shorter treatment trials (total n = 885) (13, 15, 17, 19, 22, 23), plus one long-term treatment trial ( n = 91) (25), found no evidence of an association between the two. Likewise, the four studies that examined verbal learning and memory in older-aged samples (total n = 616) found no relationship between verbal learning and memory performance and treatment-related outcomes (26, 27, 33, 34).…”

“…Three samples showed an association between poorer executive function/attention performance and poor overall treatment response (total n = 268) (13, 14, 20). Conversely, two samples showed no evidence of an association (total n = 306) (17, 20). Etkin et al (20) examined predictors of response to Escitalopram ( n = 217) and Sertraline ( n = 234).…”