Prediction of Response Within the First 3 Days to Treatment With Paroxetine for Depression

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Objective: In the treatment of depression, clinical and psychopharmacologic aspects have been investigated to predict the response to antidepressants. Some trials have reported clinical improvement as early as the first week; however, few have investigated the early effects of selective serotonin reuptake inhibitors. The aim of this study was to investigate therapeutic efficacy of paroxetine within the first 3 days of therapy onset.

Method: Subjects included 29 outpatients diagnosed at first interview with major depressive disorder according to DSM-IV criteria (June 2003 to January 2007). Paroxetine 5-20 mg/day was administered for at least 2 weeks. Treatment efficacy was defined as a > 50% decrease in Hamilton Rating Scale for Depression (HAM-D) total scores from baseline to the end of the second week. To determine efficacy within the first 3 days, patients completed the HAM-D as a self-rated questionnaire on the first and third days and at the end of the first, second, and fourth weeks.

Result: Subjects were divided into 2 groups: successful (17 responders) and failed (12 nonresponders). There was a significant difference between the reduction rates of self-rated HAM-D total scores on the third day (p < .01).

Conclusion: In patients responding to paroxetine in the early stages of treatment, the prediction of response within the first 3 days using the self-rated HAM-D is suggested.

Prim Care Companion J Clin Psychiatry 2008;10(2):129-132