![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by river1924 on August 10, 2006, at 0:23:02
EEG Predicts Depression Response to Drugs Before Treatment
NEW YORK (Reuters Health) Aug 02 - Changes in EEG patterns during a placebo lead-in phase, which is often conducted before randomization to drug treatment in clinical trials, predict response to antidepressant therapy in patients with major depressive disorder, according to a report in the August issue of the American Journal of Psychiatry.Previous studies have shown that changes in prefrontal EEG cordance after the start of antidepressant therapy are associated with clinical outcomes in patients with major depressive disorder, the authors explain.
Dr. Aimee M. Hunter and colleagues from UCLA Neuropsychiatric Institute examined the relationship between regional EEG changes (quantitative EEG theta cordance) during the 1-week placebo lead-in period and final clinical outcome among 51 depressed adults in two randomized, controlled trials of the antidepressants venlafaxine and fluoxetine.
Changes in prefrontal EEG cordance during the placebo lead-in phase were significantly associated with final Hamilton depression scale scores for patients randomized to one of the antidepressant medications, the authors report.
Decreases in prefrontal cordance were associated with lower final depression scores, the results indicate, and medication responders differed significantly from medication nonresponders.
To a similar extent, increases in right temporal cordance among patients who received placebo were associated with lower depression scores, the researchers note.
"Brain changes during the placebo lead-in phase may confound apparent medication effects associated with clinical outcomes in medication-treated subjects," the authors conclude.
The study findings suggest that "some neurophysiological changes that are associated with endpoint antidepressant outcome reflect nonpharmacodynamic factors."
"Future studies should examine how brain changes during the lead-in period may be associated with patient expectations, the therapeutic relationship, and treatment history," the investigators add.
Am J Psychiatry 2006;163:1-7.
Posted by SLS on August 10, 2006, at 6:20:57
In reply to EEG Predicts Depression Response, posted by river1924 on August 10, 2006, at 0:23:02
I wonder how long the study ran for.
- Scott
Posted by SLS on August 10, 2006, at 6:38:24
In reply to Re: EEG Predicts Depression Response, posted by SLS on August 10, 2006, at 6:20:57
> I wonder how long the study ran for.
8 weeks
The question then becomes whether or not these people were placebo responders. Placebo responders follow a pattern of early response with eventual relapse, but the relapse does not occur until after 8 weeks have elapsed. The abstract does not offer enough data to evaluate.
Another possibility is that these people demonstrated a physiological rebound effect upon the discontinuation of their previous medication whereas non-responders were physiologically less responsive to changes in pharmacological milieu.
- Scott
----------------------------------------Am J Psychiatry. 2006 Aug;163(8):1426-32. Related Articles, Links
Click here to read
Changes in brain function (quantitative EEG cordance) during placebo lead-in and treatment outcomes in clinical trials for major depression.Hunter AM, Leuchter AF, Morgan ML, Cook IA.
Semel Institute for Neuroscience and Human Behavior at UCLA, 760 Westwood Plaza, Rm. 37-359, Los Angeles, CA 90024-1759. amhunter@ucla.edu.
OBJECTIVE: Decreases in prefrontal electroencephalogram (EEG) cordance that are detectable as early as 48 hours after the start of medication have been related to clinical outcome in treatment trials for major depressive disorder. The relationship between brain changes during the placebo lead-in phase and medication treatment outcome is unknown. The authors hypothesized that decreases in prefrontal cordance during the placebo lead-in phase would be associated with better clinical outcome in subjects treated with antidepressants. METHOD: Data were pooled examining 51 adults with major depressive disorder from two independent double-blind placebo-controlled trials. A 1-week single-blind placebo lead-in phase preceded 8 weeks of randomized treatment with medication (fluoxetine 20 mg or venlafaxine 150 mg) or placebo. The authors obtained quantitative EEG cordance measures at baseline and at the end of the placebo lead-in period. Relationships between regional cordance changes at the end of the placebo lead-in period and clinical outcome (the final 17-item Hamilton Rating Scale for Depression scores) were examined using multiple linear regression analysis. RESULTS: As hypothesized, decreases in prefrontal cordance during the placebo lead-in period were associated with lower final Hamilton depression scale scores in subjects randomly assigned to medication. Prefrontal changes explained 19% of the variance in final Hamilton depression scale scores. CONCLUSIONS: Neurophysiological changes during a placebo lead-in period may serve as nonpharmacodynamic biomarkers of eventual treatment outcomes in clinical trials for major depressive disorder.
PMID: 16877657 [PubMed - in process]
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.