TY - JOUR
T1 - Psychiatric Comorbidity as a Predictor of Clinical Response to Nortriptyline in Treatment-Resistant Major Depressive Disorder
AU - Papakostas, George I.
AU - Petersen, Timothy J.
AU - Farabaugh, Amy H.
AU - Murakami, Jessica L.
AU - Pava, Joel A.
AU - Alpert, Jonathan E.
AU - Fava, Maurizio
AU - Nierenberg, Andrew A.
PY - 2003/11
Y1 - 2003/11
N2 - 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.
AB - 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.
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U2 - 10.4088/JCP.v64n1112
DO - 10.4088/JCP.v64n1112
M3 - Article
C2 - 14658951
AN - SCOPUS:0344119563
SN - 0160-6689
VL - 64
SP - 1357
EP - 1361
JO - Diseases of the Nervous System
JF - Diseases of the Nervous System
IS - 11
ER -
