An exploratory study of adolescent response to fluoxetine using psychological and biological predictors.

Ada H Zohar,Tamar Eilat,Alan Apter,Michal Taler,Romi Bari,Silvana Fennig,Avraham Weizman,Alon Chen,Maya Amitai

doi:10.7717/peerj.4240

Abstract

BackgroundNot enough is known about predicting therapeutic response to serotonin-specific reuptake inhibitors, and specifically to fluoxetine. This exploratory study used psychological and biological markers for (retrospective) prediction of treatment-response to fluoxetine in depressed and/or anxious adolescents.MethodsForty-one consecutive adolescent outpatients with a primary diagnosis of severe affective and/or anxiety disorders were assessed and treated with an open-label 8-week trial of fluoxetine. Type D personality was assessed with the 14-item questionnaire, the DS14. In addition, TNFα, IL-6, and IL-1b were measured pre- and post-treatment.ResultsThere was an elevation of Type D personality in patients, compared to the adolescent population rate. Post-treatment, 44% of patients were classified as non-responders; the relative risk of non-response for Type D personality patients was 2.8. Binary logistic regression predicting response vs. non-response showed a contribution of initial TNFα levels as well as Type D personality to non-response.ConclusionsIn this exploratory study, the most significant contributor to non-response was Type D personality. However, the measurement of Type D was not prospective, and thus may be confounded with psychiatric morbidity. The measurement of personality in psychiatric settings may contribute to the understanding of treatment response and have clinical utility.

Highlights

Serotonin-specific reuptake inhibitors (SSRIs), and in particular fluoxetine, have revolutionized the treatment of depressive and anxiety disorders, there is a sizable minorityHow to cite this article Zohar et al (2018), An exploratory study of adolescent response to fluoxetine using psychological and biological predictors
The patients with and without Type D personality were compared for symptom severity pre-treatment
Because of the initial greater depression symptom severity of the Type D adolescents, baseline depression was controlled for subsequent analyses

Summary

Introduction

Serotonin-specific reuptake inhibitors (SSRIs), and in particular fluoxetine, have revolutionized the treatment of depressive and anxiety disorders, there is a sizable minorityHow to cite this article Zohar et al (2018), An exploratory study of adolescent response to fluoxetine using psychological and biological predictors. The problem is compounded by the 4–6-week delay in clinical response in those patients who do respond The damage to those who turn out to be non-responders includes their persisting disorders and distress, their disappointment with the failure of the treatment they were given, and the decreased conditional likelihood of the efficacy of the medication prescribed. Not enough is known about predicting therapeutic response to serotoninspecific reuptake inhibitors, and to fluoxetine. This exploratory study used psychological and biological markers for (retrospective) prediction of treatmentresponse to fluoxetine in depressed and/or anxious adolescents. The measurement of personality in psychiatric settings may contribute to the understanding of treatment response and have clinical utility

Methods

Results

Discussion

Conclusion