Prophylactic efficacy of fluoxetine, escitalopram, sertraline, paroxetine, and concomitant psychotherapy in major depressive disorder: Outcome after long-term follow-up

Peselow, Eric D.; Tobia, Gabriel; Karamians, Reneh; Pizano, Demetria; IsHak, Waguih William

doi:10.1016/j.psychres.2014.11.022

Cited by 15 publications

(20 citation statements)

References 51 publications

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“…Residual symptoms other than somatic symptom were not investigated in their study. It is interesting to note that the EQ-5D score in our study was in the same range as other studies focused on depressive disorder patients 19,20…”

Section: Discussionsupporting

confidence: 68%

The impact of residual symptoms on relapse and quality of life among Thai depressive patients

Hiranyatheb

Nakawiro

Wongpakaran³

et al. 2016

NDT

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PurposeResidual symptoms of depressive disorder are major predictors of relapse of depression and lower quality of life. This study aims to investigate the prevalence of residual symptoms, relapse rates, and quality of life among patients with depressive disorder.Patients and methodsData were collected during the Thai Study of Affective Disorder (THAISAD) project. The Hamilton Rating Scale for Depression (HAMD) was used to measure the severity and residual symptoms of depression, and EQ-5D instrument was used to measure the quality of life. Demographic and clinical data at the baseline were described by mean ± standard deviation (SD). Prevalence of residual symptoms of depression was determined and presented as percentage. Regression analysis was utilized to predict relapse and patients’ quality of life at 6 months postbaseline.ResultsA total of 224 depressive disorder patients were recruited. Most of the patients (93.3%) had at least one residual symptom, and the most common was anxiety symptoms (76.3%; 95% confidence interval [CI], 0.71–0.82). After 3 months postbaseline, 114 patients (50.9%) were in remission and within 6 months, 44 of them (38.6%) relapsed. Regression analysis showed that residual insomnia symptoms were significantly associated with these relapse cases (odds ratio [OR] =5.290, 95% CI, 1.42–19.76). Regarding quality of life, residual core mood and insomnia significantly predicted the EQ-5D scores at 6 months postbaseline (B =−2.670, 95% CI, −0.181 to −0.027 and B =−3.109, 95% CI, −0.172 to −0.038, respectively).ConclusionResidual symptoms are common in patients receiving treatment for depressive disorder and were found to be associated with relapses and quality of life. Clinicians need to be aware of these residual symptoms when carrying out follow-up treatment in patients with depressive disorder, so that prompt action can be taken to mitigate the risk of relapse.

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Section: Discussionsupporting

confidence: 68%

The impact of residual symptoms on relapse and quality of life among Thai depressive patients

Hiranyatheb

Nakawiro

Wongpakaran³

et al. 2016

NDT

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“…However, the exact amount of time necessary to achieve this drop (as counted from the start of the asymptomatic period) differs per study, ranging from about 2 months (O'Leary et al 2010) to about 3 years (Judd et al 1998). Other studies do not find such a sudden drop at all, instead suggesting that the diminishing hazard of return of symptoms is a gradual process rather than a discrete one (Maj et al 1992; Shea et al 1992; Flint & Rifat, 1997; Kessing et al 1998; Van Weel-Baumgarten et al 1998; Mueller et al 1999; O'Leary et al 2000; Solomon et al 2000; Mattisson et al 2007; Dunlop et al 2012; Martínez-Amorós et al 2012; Seemüller et al 2014; Peselow et al 2015; Judd et al 2016). In particular, several studies of the long-term course of MDD show that recurrence rates stabilise only after many years, such as 2.5 years (Solomon et al 2000), 10 years (Mattisson et al 2007) or about 15 years (Kessing et al 1998).…”

Section: Resultsmentioning

confidence: 99%

“…Based on this information, a threshold can be chosen that best distinguishes those with a favourable from those with a bad prognosis, argued by Zimmerman et al (2004a) to be the best method of validating a threshold. Most of these studies show that the presence of 'subthreshold' symptoms (often called residual symptoms if occurring after an MDD episode) was associated with an enhanced risk of a (recurrent) episode or relapse (Maier et al 1997;Riso et al 1997;Judd et al 1998Judd et al , 2000Judd et al , 2016Van Londen et al 1998;Fava et al 1999;Kanai et al 2003;Taylor et al 2004;Nierenberg et al 2010;Dunlop et al 2012;Kiosses & Alexopoulos, 2013;Peselow et al 2015). One study (Romera et al 2011) did not find this increased risk.…”

Section: Severity Threshold For the Asymptomatic Rangementioning

confidence: 99%

Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review

Zwart

Jeronimus

Jonge

2018

Epidemiol Psychiatr Sci

126

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Remission can best be defined as a less symptomatic state than previously assumed (Hamilton Rating Scale for Depression, 17-item version (HAMD-17) ⩽4 instead of ⩽7), without applying a duration criterion. Duration thresholds to separate remission from recovery are not meaningful. The minimal duration of depressive symptoms to define a depressive episode should be longer than 2 weeks, although further studies are required to recommend an exact duration threshold. These results are relevant for researchers and clinicians aiming to use evidence-based depression outcomes.

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“…In order to evaluate the efficacy of the different SSRIs in relapse prevention and prophylaxis of depression, Peselow and colleagues conducted a 3-year follow-up of MDD patients who had initially responded to SSRIs. Escitalopram and fluoxetine had the highest numerical prophylactic efficacy with 36% and 33.3% of the patients remained recurrence-free, respectively, although these differences were not statistically significant [ 54 ]. These results confirm the potential benefit of long-term pharmacotherapy for treating depressive illness.…”

Section: The Serotonergic Systemmentioning

confidence: 99%

Neurobiological Mechanisms of Stress Resilience and Implications for the Aged Population

Faye

McGowan

Denny

et al. 2018

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Background:Stress is a common reaction to an environmental adversity, but a dysregulation of the stress response can lead to psychiatric illnesses such as major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and anxi-ety disorders. Yet, not all individuals exposed to stress will develop psychiatric disorders; those with enhanced stress resili-ence mechanisms have the ability to adapt successfully to stress without developing persistent psychopathology. Notably, the potential to enhance stress resilience in at-risk populations may prevent the onset of stress-induced psychiatric disorders. This novel idea has prompted a number of studies probing the mechanisms of stress resilience and how it can be manipulat-ed.Methods: Here, we review the neurobiological factors underlying stress resilience, with particular focus on the serotoninergic (5-HT), glutamatergic, and γ-Aminobutyric acid (GABA) systems, as well as the hy-pothalamic-pituitary axis (HPA) in rodents and in humans. Finally, we discuss stress resiliency in the context of aging, as the likelihood of mood disorders increases in older adults.Results: Interestingly, increased resiliency has been shown to slow aging and improved overall health and quality of life. Research in the neurobiology of stress resilience, particularly throughout the aging process, is a nascent, yet, burgeoning field.Conclusion: Overall, we consider the possible methods that may be used to induce resilient phenotypes, prophylactically in at-risk populations, such as in military personnel or in older MDD patients. Research in the mechanisms of stress resilience may not only elucidate novel targets for antidepressant treatments, but also provide novel insight about how to prevent these debilitating disorders from developing.

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Prophylactic efficacy of fluoxetine, escitalopram, sertraline, paroxetine, and concomitant psychotherapy in major depressive disorder: Outcome after long-term follow-up

Cited by 15 publications

References 51 publications

The impact of residual symptoms on relapse and quality of life among Thai depressive patients

The impact of residual symptoms on relapse and quality of life among Thai depressive patients

Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review

Neurobiological Mechanisms of Stress Resilience and Implications for the Aged Population

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