Psychiatric Comorbidity as a Predictor of Clinical Response to Nortriptyline in Treatment-Resistant Major Depressive Disorder

George I. Papakostas, Timothy J. Petersen, Amy H. Farabaugh, Jessica L. Murakami, Joel A. Pava, Jonathan E. Alpert, Maurizio Fava, Andrew A. Nierenberg

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: A number of studies of major depressive disorder suggest that psychiatric comorbidity may contribute to treatment resistance. The purpose of this study was to test whether the presence of comorbid Axis I and Axis II disorders predicts clinical response to an open trial of nortriptyline among patients with treatment-resistant depression. Method: Ninety-two outpatients with treatment-resistant DSM-III-R major depressive disorder were enrolled in a 6-week open trial of nortriptyline (Nov. 1992-Jan. 1999). The presence of comorbid Axis I and Axis II disorders was established at baseline with the use of the Structured Clinical Interview for DSM-III-R. Chi-square analyses were used to test Axis I or Axis II comorbid conditions as a predictor of clinical response to nortriptyline. Results: Thirty-nine patients (42.4%) responded to nortriptyline. The presence of avoidant personality disorder (p < .01) predicted poorer response to nortriptyline. The response rate was 16.7% for patients with and 48.6% for patients without comorbid avoidant personality disorder. No other comorbid diagnoses were found to predict clinical response in a statistically significant manner. Conclusion: The presence of avoidant personality disorder conferred a poorer prognosis in treatment-resistant depression patients treated with nortriptyline.

Original languageEnglish (US)
Pages (from-to)1357-1361
Number of pages5
JournalJournal of Clinical Psychiatry
Volume64
Issue number11
StatePublished - Nov 2003
Externally publishedYes

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Treatment-Resistant Depressive Disorder
Nortriptyline
Major Depressive Disorder
Psychiatry
Comorbidity
Personality Disorders
Diagnostic and Statistical Manual of Mental Disorders
Outpatients
Interviews
Therapeutics

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Papakostas, G. I., Petersen, T. J., Farabaugh, A. H., Murakami, J. L., Pava, J. A., Alpert, J. E., ... Nierenberg, A. A. (2003). Psychiatric Comorbidity as a Predictor of Clinical Response to Nortriptyline in Treatment-Resistant Major Depressive Disorder. Journal of Clinical Psychiatry, 64(11), 1357-1361.

Psychiatric Comorbidity as a Predictor of Clinical Response to Nortriptyline in Treatment-Resistant Major Depressive Disorder. / Papakostas, George I.; Petersen, Timothy J.; Farabaugh, Amy H.; Murakami, Jessica L.; Pava, Joel A.; Alpert, Jonathan E.; Fava, Maurizio; Nierenberg, Andrew A.

In: Journal of Clinical Psychiatry, Vol. 64, No. 11, 11.2003, p. 1357-1361.

Research output: Contribution to journalArticle

Papakostas, GI, Petersen, TJ, Farabaugh, AH, Murakami, JL, Pava, JA, Alpert, JE, Fava, M & Nierenberg, AA 2003, 'Psychiatric Comorbidity as a Predictor of Clinical Response to Nortriptyline in Treatment-Resistant Major Depressive Disorder', Journal of Clinical Psychiatry, vol. 64, no. 11, pp. 1357-1361.
Papakostas, George I. ; Petersen, Timothy J. ; Farabaugh, Amy H. ; Murakami, Jessica L. ; Pava, Joel A. ; Alpert, Jonathan E. ; Fava, Maurizio ; Nierenberg, Andrew A. / Psychiatric Comorbidity as a Predictor of Clinical Response to Nortriptyline in Treatment-Resistant Major Depressive Disorder. In: Journal of Clinical Psychiatry. 2003 ; Vol. 64, No. 11. pp. 1357-1361.
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