Selecting Methodologies for the Evaluation of Differences in Time to Response Between Antidepressants

Montgomery, Stuart; Bech, Per; Blier, Pierre; Möller, Hans‐Jürgen; Nierenberg, Andrew A.; Pinder, Roger M.; Quitkin, Frederic M.; Reimitz, Paul-Egbert; Rosenbaum, Jerrold F.; Rush, A. John; Stassen, Hans H.; Thase, Michael E.

doi:10.4088/jcp.v63n0806

Cited by 42 publications

(30 citation statements)

References 15 publications

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“…This survival analytical approach is generally considered to be the most rigorous and sensitive in detecting differences in the speed of response of antidepressants (Montgomery et al, 2002). Indeed, this method has the advantage that the parameter of interest (in this case, the time to early improvement and response) is calculated individually for each patient rather than from group means and can therefore be more reliably determined (Thase, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…It is also necessary for the comparator drugs to be used under standards of equal comparison. In particular, rapid dose titration should be used where indicated (for both comparator and test drug) to ensure the earliest possible improvement in the greatest number of patients (Montgomery et al, 2002). Finally, the level of severity of depression is another important factor in detecting early changes (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…This delayed therapeutic effect of antidepressant treatment is highly problematic because it prolongs the physical, psychological, and social impairment associated with depression. Furthermore, the delayed onset of antidepressant effect increases the risks of premature discontinuation of treatment, thereby eliminating the benefits of sustained therapy, and reduces compliance (Montgomery et al, 2002). Patient suffering, family distress, and the direct and indirect costs associated with lost productivity are all increased by the delayed onset of antidepressive effect.…”

Section: Introductionmentioning

confidence: 99%

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Onset of action of escitalopram compared with other antidepressants: results of a pooled analysis

Kasper

Spadone

Verpillat³

et al. 2006

International Clinical Psychopharmacology

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In general, antidepressant drugs are regarded as too slow acting. Most patients who benefit from treatment require more than 2 weeks of therapy to respond to treatment. An efficacious and well-tolerated antidepressant drug with an earlier onset of effect would be of greater interest to clinicians and patients. To study the onset of effect of escitalopram, a selective serotonin reuptake inhibitor (SSRI), data were pooled from controlled randomized clinical double-blind trials comparing this drug with other antidepressant drugs (SSRIs and venlafaxine XR) in major depressive disorder (MDD), with assessments of the primary efficacy parameter [mean change in the Montgomery-Asberg Depression Rating Scale (MADRS) total score from baseline, using last observation carried forward]. The mean change in MADRS total scores was significantly higher for escitalopram-treated patients than for patients treated with the comparators on day 7 (-3.9 versus -3.4, respectively, P = 0.029). This difference remained significant and in favour of escitalopram at all subsequent assessments. Using secondary outcomes (Clinical Global Impression of Improvement and Severity scales and early improvement), the results consistently showed a statistically significantly faster onset of effect of escitalopram compared to other antidepressants. In conclusion, by using the MADRS scale and pooling data from the escitalopram clinical trials in MDD comparing escitalopram with other active antidepressant drugs, escitalopram was shown to be a fast-acting antidepressant with a more rapid onset of effect than the comparators, particularly other SSRIs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Onset of action of escitalopram compared with other antidepressants: results of a pooled analysis

Kasper

Spadone

Verpillat³

et al. 2006

International Clinical Psychopharmacology

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“…There has been much research and controversy around the issue of how to measure the onset (Leon, 2001 ;Montgomery et al, 2002) and the nature of early clinical actions of ADs. Recent research has produced evidence counter to the notion that there is a time lag of several weeks between the almost immediate neurochemical actions of the drugs and changes in clinical behaviour (Gelenberg and Chesen, 2000 ;Katz et al, 1996Katz et al, /1997Parker et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

A multivantaged behavioural method for measuring onset and sequence of the clinical actions of antidepressants

Katz

Houston

Brannan³

et al. 2004

Int. J. Neuropsychopharm.

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An aim in development of new antidepressants (ADs) now includes increasing speed of action. New drugs are tested primarily in outpatients who are less severely depressed than the patients treated in earlier trials of the tricyclic drugs. To determine early efficacy requires measures sensitive to initial changes in components of the illness as well as in the severity of the entire syndrome of depression. This paper describes the development of a brief 'multivantaged' (MV) method for assessing the major behavioural and affective components of depression. The revised Brief MV was significantly reduced from the original to make it more feasible to apply in outpatient studies. In this study we determined the Brief MV's (1) reliability and comparability to the original and (2) its ability to detect the onset of specific behavioural effects in outpatients treated with paroxetine for 6 wk. The latter is compared to the ability of the Hamilton Depression Scale (HAMD) to detect changes in global severity. The constructs derived from the Brief MV were found to be highly similar to those of the original version and as reliable. In depressed patients who responded to paroxetine, the HAMD and MV detected onset of improvement after 7 d of treatment. The Brief MV revealed that the improvement in global severity was due to the drug's action at this time on behaviours such as anxiety and distressed expression, as well as on a severity dimension of anxiety-agitation-somatization. Thus, the Brief MV, in uncovering underlying behavioural actions, represents an important addition to the current unidimensional HAMD approach in drug research.

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“…We used a survival analytical approach which is generally considered to be the most rigorous and sensitive in detecting differences between antidepressant efficacy [44] and we focused on pragmatic outcome measures across a national health insurance database. This study contributes to reflections on a potential hierarchy among SSRIs and could be confirmed by larger pharmacoepidemiology studies with greater population representativeness and more clinical outcomes.…”

Section: Resultsmentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors, are They All Equal? A Pharmacoepidemiological Study

Peron¹,

JB²

2016

Adv Pharmacoepidemiol Drug Saf

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Introduction: According to the French health authorities' guidelines relative to depression and anxiety disorder treatments, six Selective Serotonin Reuptake Inhibitors are available for prescription as a first-line of treatment. The guidelines suggest equivalence between these treatment options, but studies diverge regarding efficacy and safety profiles. Moreover, conditions in clinical trials are strictly controlled and do not truly reflect real life utilization. The objective of this study was to evaluate differences in efficacy and/or safety between these six selective serotonin reuptake inhibitors in real conditions of use.

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Selecting Methodologies for the Evaluation of Differences in Time to Response Between Antidepressants

Cited by 42 publications

References 15 publications

Onset of action of escitalopram compared with other antidepressants: results of a pooled analysis

Onset of action of escitalopram compared with other antidepressants: results of a pooled analysis

A multivantaged behavioural method for measuring onset and sequence of the clinical actions of antidepressants

Selective Serotonin Reuptake Inhibitors, are They All Equal? A Pharmacoepidemiological Study

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