Gerard E Bruder1, Jorge E Alvarenga2, Daniel Alschuler2, Karen Abraham2, John G Keilp3, David J Hellerstein4, Jonathan W Stewart4, Patrick J McGrath4. 1. Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA; Division of Cognitive Neuroscience, New York State Psychiatric Institute, New York, NY, USA. Electronic address: bruderg@nyspi.columbia.edu. 2. Division of Cognitive Neuroscience, New York State Psychiatric Institute, New York, NY, USA. 3. Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA; Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, New York, NY, USA. 4. Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA; Depression Evaluation Service, New York State Psychiatric Institute, New York, NY, USA.
Abstract
BACKGROUND: Executive dysfunction and psychomotor slowing in depressed patients have been associated with poor antidepressant clinical response, but little is known about the value of neurocognitive tests for differential prediction of response. METHODS: This report presents new findings for 70 depressed patients tested on neurocogntive tests before receiving treatment with aSSRI (escitalopram or citalopram), NDRI (bupropion) or dual mechanism therapy including a serotonergic agent, and for 57 healthy controls. RESULTS: As predicted from previous research, patients who did not respond to a SSRI or dual therapy showed poorer word fluency than responders, whereas this was not seen for patients treated with bupropion alone. Longer choice reaction time (RT) was also found in nonresponders to a SSRI or dual therapy, but the opposite trend was seen for bupropion. Using a combined index of word fluency and RT (with normative performance as a cutoff) yielded differential predictions of response. Equal to or above normal performance predicted good response to a SSRI or dual therapy, with high positive predictive value (90%) and specificity (78%) but lower sensitivity (53%). In contrast, less than normal performance predicted good response to bupropion alone (positive predictive value=82%; specificity=67%; sensitivity=90%). LIMITATIONS: Relatively small sample size, no placebo control, and combining across SSRI alone and dual treatments. CONCLUSIONS: Although findings are preliminary due to small sample size, brief tests of word fluency and psychomotor speed may help identify depressed patients who are unresponsive to a serotonergic agent, but who may respond to bupropion alone.
RCT Entities:
BACKGROUND: Executive dysfunction and psychomotor slowing in depressedpatients have been associated with poor antidepressant clinical response, but little is known about the value of neurocognitive tests for differential prediction of response. METHODS: This report presents new findings for 70 depressedpatients tested on neurocogntive tests before receiving treatment with a SSRI (escitalopram or citalopram), NDRI (bupropion) or dual mechanism therapy including a serotonergic agent, and for 57 healthy controls. RESULTS: As predicted from previous research, patients who did not respond to a SSRI or dual therapy showed poorer word fluency than responders, whereas this was not seen for patients treated with bupropion alone. Longer choice reaction time (RT) was also found in nonresponders to a SSRI or dual therapy, but the opposite trend was seen for bupropion. Using a combined index of word fluency and RT (with normative performance as a cutoff) yielded differential predictions of response. Equal to or above normal performance predicted good response to a SSRI or dual therapy, with high positive predictive value (90%) and specificity (78%) but lower sensitivity (53%). In contrast, less than normal performance predicted good response to bupropion alone (positive predictive value=82%; specificity=67%; sensitivity=90%). LIMITATIONS: Relatively small sample size, no placebo control, and combining across SSRI alone and dual treatments. CONCLUSIONS: Although findings are preliminary due to small sample size, brief tests of word fluency and psychomotor speed may help identify depressedpatients who are unresponsive to a serotonergic agent, but who may respond to bupropion alone.
Authors: R Schlösser; M Hutchinson; S Joseffer; H Rusinek; A Saarimaki; J Stevenson; S L Dewey; J D Brodie Journal: J Neurol Neurosurg Psychiatry Date: 1998-04 Impact factor: 10.154
Authors: H S Mayberg; S K Brannan; R K Mahurin; P A Jerabek; J S Brickman; J L Tekell; J A Silva; S McGinnis; T G Glass; C C Martin; P T Fox Journal: Neuroreport Date: 1997-03-03 Impact factor: 1.837
Authors: J J Dunkin; A F Leuchter; I A Cook; J E Kasl-Godley; M Abrams; S Rosenberg-Thompson Journal: J Affect Disord Date: 2000-10 Impact factor: 4.839
Authors: D G Dillon; T Wiecki; P Pechtel; C Webb; F Goer; L Murray; M Trivedi; M Fava; P J McGrath; M Weissman; R Parsey; B Kurian; P Adams; T Carmody; S Weyandt; K Shores-Wilson; M Toups; M McInnis; M A Oquendo; C Cusin; P Deldin; G Bruder; D A Pizzagalli Journal: Psychol Med Date: 2015-03-02 Impact factor: 7.723
Authors: Yuen-Siang Ang; Roselinde Kaiser; Thilo Deckersbach; Jorge Almeida; Mary L Phillips; Henry W Chase; Christian A Webb; Ramin Parsey; Maurizio Fava; Patrick McGrath; Myrna Weissman; Phil Adams; Patricia Deldin; Maria A Oquendo; Melvin G McInnis; Thomas Carmody; Gerard Bruder; Crystal M Cooper; Cherise R Chin Fatt; Madhukar H Trivedi; Diego A Pizzagalli Journal: Biol Psychiatry Date: 2020-04-23 Impact factor: 13.382
Authors: Natania A Crane; Lisanne M Jenkins; Runa Bhaumik; Catherine Dion; Jennifer R Gowins; Brian J Mickey; Jon-Kar Zubieta; Scott A Langenecker Journal: Brain Date: 2017-01-24 Impact factor: 13.501
Authors: Ronit Kishon; Karen Abraham; Daniel M Alschuler; John G Keilp; Jonathan W Stewart; Patrick J McGrath; Gerard E Bruder Journal: Psychiatry Res Date: 2015-06-11 Impact factor: 3.222
Authors: Diego A Pizzagalli; Christian A Webb; Daniel G Dillon; Craig E Tenke; Jürgen Kayser; Franziska Goer; Maurizio Fava; Patrick McGrath; Myrna Weissman; Ramin Parsey; Phil Adams; Joseph Trombello; Crystal Cooper; Patricia Deldin; Maria A Oquendo; Melvin G McInnis; Thomas Carmody; Gerard Bruder; Madhukar H Trivedi Journal: JAMA Psychiatry Date: 2018-06-01 Impact factor: 21.596
Authors: David R Goldsmith; Ebrahim Haroon; Bobbi J Woolwine; Moon Y Jung; Evanthia C Wommack; Philip D Harvey; Michael T Treadway; Jennifer C Felger; Andrew H Miller Journal: Brain Behav Immun Date: 2016-04-01 Impact factor: 7.217