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Cited by 111Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Predictors of Relapse in a Prospective Study of Fluoxetine Treatment of Major Depression

McGrath, Patrick J., Stewart, Jonathan W., Quitkin, Frederic M., Chen, Ying, Alpert, Jonathan E., Nierenberg, Andrew A., Fava, Maurizio, Cheng, Jianfeng +1 more·2006·American Journal of Psychiatry
DOI 10.1176/ajp.2006.163.9.1542
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Abstract

OBJECTIVE: Loss of response to a previously effective antidepressant is a common clinical problem. Retrospective analyses have shown that the pattern of response during antidepressant treatment (late onset and persistent versus other patterns) can be used to predict relapse during continuation and maintenance treatment and possibly to identify placebo responses to treatment. This study was designed to test the predictive value of response pattern prospectively and to examine the data for other predictors of relapse. METHOD: Five hundred seventy persons with major depressive disorder were treated with fluoxetine for 12 weeks and their pattern of response was determined. Those who responded (N=292) underwent random assignment, under double-blind conditions, to continue taking fluoxetine or to switch to placebo for 52 weeks or until relapse. Survival analysis was used to examine the effect of covariates on relapse. RESULTS: Although fluoxetine was significantly more effective than placebo during maintenance treatment, this chronically ill group had a high rate of relapse. Contrary to previous findings, a pattern of acute response was not predictive of relapse. Chronicity, symptom severity, a neurovegetative symptom pattern, and female gender were all associated with a significantly greater risk of relapse, with no difference observed between fluoxetine and placebo. CONCLUSIONS: The pattern of response to acute treatment appears to be inconsistently predictive of relapse. There is a high rate of relapse with both active medication and placebo in patients with chronic depression. Illness characteristics predict loss of response both to fluoxetine and to placebo. No variable examined was predictive of differential relapse rates between fluoxetine and placebo.

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Crossref · 10.1176/ajp.2006.163.9.1542

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  • Melancholic subtype did not interact significantly with treatment in McGrath et al. (2006).

    “Melancholic subtype did not interact significantly with treatment in the study by McGrath et al. (2006).”

    From Predicting relapse after antidepressant withdrawal – a systematic review (2017) · cites this paper as McGrath et al. (2006)

  • The interaction of treatment and neurovegetative symptoms alone was not significant in McGrath et al. (2006).

    “The interaction of treatment and neurovegetative symptoms alone was not reported by McGrath et al. (2000) and was not significant in a later trial by the same authors (McGrath et al. 2006).”

    From Predicting relapse after antidepressant withdrawal – a systematic review (2017) · cites this paper as McGrath et al. (2006)

  • McGrath et al. (2006) failed to find a significant interaction between response pattern and discontinuation.

    “McGrath et al. (2006) failed to find a significant interaction between response pattern and discontinuation.”

    From Predicting relapse after antidepressant withdrawal – a systematic review (2017) · cites this paper as McGrath et al. (2006)

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Authors
McGrath, P. J., Stewart, J. W., Quitkin, F. M., Chen, Y., Alpert, J. E., Nierenberg, A. A., Fava, M., Cheng, J., & Petkova, E.
Affiliations
New York State Psychiatric Institute (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2006-09
Volume
163
Issue
9
Pages
1542-1548
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/ajp.2006.163.9.1542
OpenAlex
W2116416511
Cited by
111
References
2
Citations by year
2025: 2 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 5 · 2015: 8 · 2014: 4 · 2013: 5 · 2012: 5
FWCI
6.90
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01-MH56058)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
major depressive disorder, fluoxetine, recurrence prediction, loss of response, chronic depression, maintenance therapy, placebo response, neurovegetative symptoms, symptom severity, female gender, predictors of relapse
MeSH terms
Adult, Chronic Disease, Major Depressive Disorder, Depressive Disorder, Major, Double-Blind Method, Drug Resistance, Female, Fluoxetine, Humans, Male, Placebos, Prospective Studies, Risk Factors, Severity of Illness Index, Sex Factors, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Secondary Prevention

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