Psychomotor slowing as a predictor of fluoxetine nonresponse in depressed outpatients
Abstract
OBJECTIVE: This study examined the utility of baseline psychomotor speed, measured with neuropsychological tests, to predict fluoxetine response in moderately depressed outpatients. The authors hypothesized that since psychomotor slowing in depressed patients has been linked to reduced dopaminergic neurotransmission, patients with slowing would be unresponsive to fluoxetine, a selective serotonin reuptake inhibitor. METHOD: After baseline neuropsychological testing, patients were treated openly with fluoxetine for 12 weeks. Thirty-seven patients completed the trial. RESULTS: Compared to the 25 patients who responded, the 12 patients who did not respond to fluoxetine exhibited significantly poorer performance in verbal fluency on the Controlled Oral Word Association Test FAS and in color naming on the Stroop Color and Word Test. In addition, the nonresponders tended to perform worse than the responders on the Stroop Color and Word Test reading subtest and the WAIS-III digit symbol subtest. Differential treatment response was specific to psychomotor speed because responders and nonresponders did not perform differently on tasks of executive functioning, attention, visuospatial functioning, or verbal intelligence. CONCLUSIONS: Psychomotor slowing may identify a subgroup of depressed patients who have a dopaminergic deficit that is unresponsive to fluoxetine monotherapy and who should therefore receive an alternative treatment.
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Psychomotor retardation is a common symptom of depression.
“Psychomotor retardation, defined as a slowing of motor activity and difficulty responding quickly and spontaneously to environmental cues, is a common symptom of depression (Taylor et al., 2006).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Taylor et al., 2006
A neurocognitive profile characterized by psychomotor slowing may aid in the identification of a subgroup of patients with major depressive disorder who are less likely to respond to selective serotonin reuptake inhibitor monotherapy.
“Conversely, a neurocognitive profile characterized by psychomotor slowing may aid in the identification of a subgroup of patients with MDD who are less likely to respond to SSRI monotherapy [73].”
From Cognitive remission: a novel objective for the treatment of major depression? (2016) · cites this paper as [73]
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- Authors
- Taylor, B. P., Bruder, G. E., Stewart, J. W., McGrath, P. J., Halperin, J., Ehrlichman, H., & Quitkin, F. M.
- Affiliations
- Columbia University Irving Medical Center (US)
- Venue
- American Journal of Psychiatry
- Published
- 2006-01-01
- Volume
- 163
- Issue
- 1
- Pages
- 73-78
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2133715864
- Cited by
- 109
- References
- 32
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 5 · 2018: 11 · 2017: 5 · 2016: 7 · 2015: 8 · 2014: 5 · 2013: 8 · 2012: 3
- FWCI
- 3.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- psychomotor retardation, fluoxetine, antidepressant non-response, depression, outpatients, treatment response prediction, dopaminergic deficit, selective serotonin reuptake inhibitors, neuropsychological assessment, verbal fluency, Stroop task, Controlled Oral Word Association Test, Digit Symbol Substitution Test, executive function
- MeSH terms
- Adolescent, Adult, Aged, Ambulatory Care, Major Depressive Disorder, Dopamine, Female, Fluoxetine, Humans, Male, Middle Aged, Synaptic Transmission, Neuropsychological Tests, Probability, Psychiatric Status Rating Scales, Psychomotor Performance, Risk Factors, Severity of Illness Index, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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