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Original Research

Somatic Symptoms as Predictors of Time to Onset of Response to Fluoxetine in Major Depressive Disorder

George I. Papakostas, MD; Timothy J. Petersen, PhD; Dan V. Iosifescu, MD; Paul Summergrad, MD; Katherine G. Sklarsky, BA; Jonathan E. Alpert, MD, PhD; Andrew A. Nierenberg, MD; and Maurizio Fava, MD

Published: April 1, 2004

Article Abstract
Objective: In the present study we assessed the relationship between somatic symptoms and the time to onset of clinical response to fluoxetine in patients with major depressive disorder (MDD).


Method: 87 outpatients (mean age = 41.4 ± 10.2 years; 59.8% women) with DSM-III-R MDD who had sustained acute response to fluoxetine completed the Symptom Questionnaire (SQ) at baseline. Onset of response was defined as a 30% decrease in the total score for the 17-item Hamilton Rating Scale for Depression that led to a 50% decrease by week 8. With the use of 2 separate multiple regressions, controlling for the severity of depression at baseline, we then assessed the relationship between the number of somatic symptoms as assessed by the SQ subscale for somatic symptoms (SQ-SS) and both the time to onset of clinical response and the time to clinical response. The study was conducted between November 1992 and January 1999.

Results: A greater number of somatic symptoms at baseline predicted a greater amount of time to onset of clinical response to fluoxetine (p = .0233). The relationship between SQ-SS scores and time to response was not found to be statistically significant (p > .05).

Conclusion: Somatic symptoms of depression were found to be associated with a delayed onset of antidepressant response to fluoxetine in MDD.

Volume: 65

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