Early nonresponse to fluoxetine as a predictor of poor 8-week outcome

A. A. Nierenberg, N. E. McLean, Jonathan E. Alpert, J. J. Worthington, J. F. Rosenbaum, M. Fava

Research output: Contribution to journalArticle

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Abstract

Objective: The purpose of this study was to quantify the proportion of patients who show no response to a fixed dose of fluoxetine after 2, 4, and 6 weeks of treatment and then respond by week 8. Method: In an open trial, 143 outpatients who met DSM-III-R criteria for major depressive disorder were treated with a regimen of fluoxetine, 20 mg/day. The authors analyzed the proportion of patients who had less than a 20% decrease from baseline in their scores on the Hamilton Rating Scale for Depression after 2, 4, and 6 weeks and who went on to have a 50% or greater reduction by week 8. A last- observation-carried-forward strategy was used to calculate conditional probabilities of 8-week response. Kaplan-Meier survival analysis was used to estimate probabilities of response at week 8 given degrees of response at week 2. Results: Eighty-two subjects (57.3%) who started the trial responded by week 8. Of those subjects who showed no improvement at weeks 2, 4, and 6, the proportions of responders at week 8 were 36.4%, 18.9%, and 6.5%, respectively. The Kaplan-Meier estimate of 8-week response given nonresponse at week 2 was 0.45. Conclusions: The proportion of patients with no response to antidepressant treatment by 4 or 6 weeks who responded by week 8 was substantially less than that for subjects who had at least a partial response. Nonresponse as early as week 2 predicted 8-week outcome.

Original languageEnglish (US)
Pages (from-to)1500-1503
Number of pages4
JournalAmerican Journal of Psychiatry
Volume152
Issue number10
StatePublished - 1995
Externally publishedYes

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Fluoxetine
Kaplan-Meier Estimate
Major Depressive Disorder
Survival Analysis
Diagnostic and Statistical Manual of Mental Disorders
Antidepressive Agents
Outpatients
Observation
Depression
Therapeutics

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Nierenberg, A. A., McLean, N. E., Alpert, J. E., Worthington, J. J., Rosenbaum, J. F., & Fava, M. (1995). Early nonresponse to fluoxetine as a predictor of poor 8-week outcome. American Journal of Psychiatry, 152(10), 1500-1503.

Early nonresponse to fluoxetine as a predictor of poor 8-week outcome. / Nierenberg, A. A.; McLean, N. E.; Alpert, Jonathan E.; Worthington, J. J.; Rosenbaum, J. F.; Fava, M.

In: American Journal of Psychiatry, Vol. 152, No. 10, 1995, p. 1500-1503.

Research output: Contribution to journalArticle

Nierenberg, AA, McLean, NE, Alpert, JE, Worthington, JJ, Rosenbaum, JF & Fava, M 1995, 'Early nonresponse to fluoxetine as a predictor of poor 8-week outcome', American Journal of Psychiatry, vol. 152, no. 10, pp. 1500-1503.
Nierenberg AA, McLean NE, Alpert JE, Worthington JJ, Rosenbaum JF, Fava M. Early nonresponse to fluoxetine as a predictor of poor 8-week outcome. American Journal of Psychiatry. 1995;152(10):1500-1503.
Nierenberg, A. A. ; McLean, N. E. ; Alpert, Jonathan E. ; Worthington, J. J. ; Rosenbaum, J. F. ; Fava, M. / Early nonresponse to fluoxetine as a predictor of poor 8-week outcome. In: American Journal of Psychiatry. 1995 ; Vol. 152, No. 10. pp. 1500-1503.
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