Which Depressed Patients Respond to Nefazodone and When?
J Clin Psychiatry 2001;62(3):158-163
© Copyright 2017 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Retrospective data analyses were
conducted of a single-blind trial of 993 outpatients with
nonpsychotic major depression (DSM-III-R) treated for 12 weeks
with nefazodone to provide a more specific picture of the nature
and timing of response or remission to acute-phase treatment.
Method: All patients participated in a
single-blind, 16-week lead-in to obtain responders eligible for a
subsequent double-blind, randomized continuation phase trial.
Outcomes were defined by the 17-item Hamilton Rating Scale for
Depression (HAM-D). A >= 50% reduction from baseline defined
response, and a total HAM-D exit score of <= 8 defined
Results: Of all patients who entered the trial,
41.8% (last observation carried forward) responded at or before
week 4 (early responders), and an additional 25.2% responded
thereafter; 18.3% achieved remission at or before week 4; 33.6%
achieved remission after week 4. Thus, 77.3% of those responding
ultimately remitted. On average, remission followed response by 2
weeks. The average end-of-treatment dose was 376 mg/day at exit
(last observation carried forward). Responders or remitters (as
opposed to nonresponders or nonremitters) had lower baseline
depressive symptomatology and were more likely to be married or
Conclusion: The full symptomatic benefit of
antidepressant medication may not be apparent until completion of
an 8- to 10-week trial. A high number of responders ultimately
attained remission. Baseline demographic and clinical features
were not highly predictive of who would or would not benefit from
nefazodone. For routine care, a minimal acute-phase trial, using
a 50% reduction in baseline symptom severity to define response,
should be 8 weeks. Whether ultimate nonresponders can be
identified earlier than 8 weeks deserves further study.