Psychiatric Comorbidity as a Predictor of Clinical Response to Nortriptyline in Treatment-Resistant Major Depressive Disorder
J Clin Psychiatry 2003;64(11):1357-1361
© Copyright 2015 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: 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.