How Should Remission From Depression Be Defined? The Depressed Patient’s Perspective

Zimmerman, Mark; McGlinchey, Joseph B.; Posternak, Michael A.; Friedman, Michael; Attiullah, Naureen; Boerescu, Daniela A.

doi:10.1176/appi.ajp.163.1.148

Cited by 369 publications

(281 citation statements)

References 13 publications

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“…28 When considering optimal antidepressant treatment, patients often describe the importance of both symptom resolution and normalization of functioning. 29 Levomilnacipran SR demonstrated efficacy and generally good tolerability in this clinical trial of patients with MDD. Consistent with what patients identify as the important components of recovery, levomilnacipran SR significantly improved both depressive symptoms and functional impairment in patients with MDD.…”

Section: Discussionmentioning

confidence: 73%

Efficacy and Safety of Levomilnacipran Sustained Release 40 mg, 80 mg, or 120 mg in Major Depressive Disorder

Asnis¹,

Bose²,

Gommoll³

et al. 2013

J. Clin. Psychiatry

125

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Objective: This phase 3, randomized, double-blind, placebo-controlled study evaluated the efficacy and tolerability of fixed-dose levomilnacipran sustained release (SR) compared with placebo in patients with major depressive disorder (MDD); the study was conducted from September 2009-May 2011.Method: Outpatients met DSM-IV-TR criteria for MDD with an ongoing major depressive episode ≥ 8 weeks' duration. After a 1-week placebo lead-in, patients were randomly assigned to receive placebo (n = 179) or levomilnacipran SR 40 mg (n = 181), 80 mg (n = 181), or 120 mg (n = 183) once daily for 8 weeks of double-blind treatment, followed by a 2-week double-blind down-taper. The primary efficacy parameter was change from baseline on the clinician-rated Montgomery-Asberg Depression Rating Scale (MADRS) total score. The prespecified secondary efficacy parameter was change from baseline in Sheehan Disability Scale (SDS) total score. Additional efficacy measures included the 17-item Hamilton Depression Rating Scale (HDRS 17 ) and Clinical Global Impressions-Severity of Illness (CGI-S) and -Improvement (CGI-I). Safety and tolerability were also evaluated. Results:The least squares mean difference (LSMD) for change from baseline in MADRS total score was significantly superior to placebo for all dose groups: −3.23 (P = .0186), −3.99 (P = .0038), and −4.86 (P = .0005) for levomilnacipran SR 40, 80, and 120 mg, respectively. The LSMD was significantly different for levomilnacipran SR 80 mg and 120 mg versus placebo on the SDS (−2.51 and −2.57, respectively, P < .05 for both doses), HDRS 17 (−2.09 and −2.34, respectively, P < .05 for both doses), CGI-S (−0.43 [P < .01] and −0.35 [P < .05], respectively), and CGI-I (−0.34 and −0.32, respectively, P < .05 for both doses) assessments. The most common treatmentemergent adverse events (≥ 10% of any treatment group) were headache, nausea, constipation, dry mouth, increased heart rate, and hyperhidrosis.Conclusions: Levomilnacipran SR demonstrated significant improvement in depressive symptoms and functioning relative to placebo. In this study, levomilnacipran SR was generally well tolerated. September 28, 2012; accepted January 28, 2013 (doi:10.4088/JCP.12m08197 T he complex nature of major depressive disorder (MDD) suggests that recovery may be most appropriately judged by multiple factors. Even when patients achieve symptom improvement, impaired social and occupational functioning may persist and interfere with well-being. As such, it has been suggested that return to wellness in patients with MDD may be better defined by evaluating a combination of symptoms, functional status, and pathophysiologic changes. Submitted:1 The development of effective and safe new medications that address all aspects of MDD treatment is essential.Levomilnacipran (1S, 2R-milnacipran) is a potent and selective serotonin-norepinephrine reuptake inhibitor (SNRI) in late-stage clinical development for treatment of MDD in adults. A sustained release (SR) formulation of levomilnacipran was developed to al...

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Section: Discussionmentioning

confidence: 73%

Efficacy and Safety of Levomilnacipran Sustained Release 40 mg, 80 mg, or 120 mg in Major Depressive Disorder

Asnis¹,

Bose²,

Gommoll³

et al. 2013

J. Clin. Psychiatry

125

View full text Add to dashboard Cite

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“…The importance of the daily experience of positive emotion in well being and recovery from psychiatric disease is underscored as mood disorder patients highlight increases in positive affect as being central to recovery (Zimmerman et al, 2006). Patients in treatment spend Ͻ1% of their weekly waking life in therapy, yet it is effective for many.…”

Section: Discussionmentioning

confidence: 99%

The Neurodynamics of Affect in the Laboratory Predicts Persistence of Real-World Emotional Responses

Heller

Fox

Wing

et al. 2015

Journal of Neuroscience

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“…Additionally, positive aspects of mental health, such as optimism, vigor, and selfconfidence have been shown to be better indicators of remission than the absence of depressive symptoms [16]. Recently, resilience has been identified as a factor [17] that can be improved through intervention [18].…”

Section: Introductionmentioning

confidence: 99%

Resilience in the First Episode of Major Depressive Disorder

Maekawa¹,

Souda²,

Oyakawa³

et al. 2017

OJMP

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Aim: Resilience refers to the human ability to adapt to tragedy, trauma, adversity, and significant stressors. Recently, resilience has been defined as a potentially modifiable factor that can be improved through intervention. Here, we examined resilience during a 3-month period as patients experienced their first episode of major depressive disorder (MDD). We hypothesized that despite MDD, resilient people could recover from depressive states more quickly than less resilient people. Methods: Twelve patients experienced their first MDD episode and 21 healthy control individuals participated in the study. Data from the Hamilton Depression Rating Scale (HAM-D), S-H Resilience Scale (S-HRS), and State-Trait Anxiety Index (STAI) were collected at two time points. Time 1 was the first visit after registration and Time 2 was 12 weeks later. Based on the symptoms described by the HAM-D results, the MDD group was divided into MDD-remission and MDD-residual subgroups. Results: Compared with controls, patients showed significantly lower resilience (low scores for Factor-A, Factor-B, and total S-HRS). Moreover, total SHRS scores for the MDD-remission group increased significantly from the Time 1 to Time 2, while those in MDD-residual group did not change. No significant differences in STAI scores were observed between MDD-remission and MDD-residual groups at either time point. Conclusion: This is the first report to show that patients experiencing their first episode of MDD show low resilience, and that a resilience scale might be a good index for estimating recovery from depression.

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How Should Remission From Depression Be Defined? The Depressed Patient’s Perspective

Abstract: Patients aspire to a range of outcomes from the treatment of their depression.

Cited by 369 publications

References 13 publications

Efficacy and Safety of Levomilnacipran Sustained Release 40 mg, 80 mg, or 120 mg in Major Depressive Disorder

Efficacy and Safety of Levomilnacipran Sustained Release 40 mg, 80 mg, or 120 mg in Major Depressive Disorder

The Neurodynamics of Affect in the Laboratory Predicts Persistence of Real-World Emotional Responses

Resilience in the First Episode of Major Depressive Disorder

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