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Cited by 62Treatment of Major DepressionLipoproteins and Cardiovascular HealthTryptophan and brain disorders

Elevated Cholesterol Levels Associated with Nonresponse to Fluoxetine Treatment in Major Depressive Disorder

Sonawalla, Shamsah B., Papakostas, George I., Petersen, Timothy J., Yeung, Albert S., Smith, Megan M., Sickinger, Andrea H., Gordon, Johanna, Israel, Joshua A. +3 more·2002·Psychosomatics
DOI 10.1176/appi.psy.43.4.310
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Abstract

Previous studies have suggested that patients with major depressive disorder may have lower cholesterol levels compared to healthy controls. The purpose of this study was to examine the relationship between pretreatment serum cholesterol levels and clinical response to treatment with fluoxetine among outpatients with major depression. Three hundred and twenty-two depressed outpatients meeting DSM-III-R criteria for major depressive disorder were enrolled in an 8-week, fixed-dose, open trial of fluoxetine 20 mg/day. Nonfasting serum cholesterol levels were obtained for all patients before starting fluoxetine. All patients were drug free for a minimum of 2 weeks prior to the onset of the study. Clinical response was defined as a 50% or greater decrease in the 17-item Hamilton Rating Scale for Depression (HAM-D-17) score at endpoint compared to baseline. Cholesterol levels were classified as either elevated (defined as a level equal to or greater than 200 mg/dL) or nonelevated (defined as a level less than 200 mg/dL). Among the 322 outpatients, 51.6% were classified as having elevated and 48.4% as having nonelevated cholesterol levels at baseline (mean cholesterol level 238.6 +/- 33.4 mg/dL vs. 170.4 +/- 22.2 mg/dL, respectively). Depressed patients with elevated cholesterol levels did not significantly differ in gender ratio but were significantly older than depressed patients with nonelevated cholesterol levels (P <.0001). After adjusting for age, gender, and Body Mass Index (BMI), depressed patients with elevated cholesterol levels were significantly more likely to be nonresponders to fluoxetine treatment than were depressed patients with nonelevated cholesterol levels (P < 0.05). Elevated serum cholesterol levels appear to be associated with poorer response to fluoxetine treatment. Further studies are needed to confirm our findings.

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Authors
Sonawalla, S. B., Papakostas, G. I., Petersen, T. J., Yeung, A. S., Smith, M. M., Sickinger, A. H., Gordon, J., Israel, J. A., Tedlow, J. R., Lamon-Fava, S., & Fava, M.
Affiliations
Harvard University (US)
Corresponding author
Sonawalla, Shamsah B.
ORCID
Venue
Psychosomatics
Publisher
Elsevier BV
Published
2002-07
Volume
43
Issue
4
Pages
310-316
ISSN
0033-3182 (ISSN-L)
DOI
10.1176/appi.psy.43.4.310
OpenAlex
W2140141605
Cited by
62
References
58
Citations by year
2025: 1 · 2024: 2 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 5 · 2015: 5 · 2014: 4 · 2012: 4
FWCI
2.22
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Psychosomatics (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01MH48483-05)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Keywords
major depressive disorder, serum cholesterol, elevated cholesterol, fluoxetine, treatment non-response, antidepressant response, outpatients, age differences, body mass index
MeSH terms
Adult, Analysis of Variance, Cholesterol, Depressive Disorder, Female, Fluoxetine, Humans, Male, Middle Aged, Chi-Square Distribution, Logistic Models, Treatment Failure, Antidepressive Agents, Second-Generation

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