Impact of morbid obesity on treatment outcome in a clinical trial of major depressive disorder

Targum, Steven D.; Catania, Christopher J.

doi:10.1016/j.pmip.2017.06.002

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…In a previous analysis, we demonstrated that morbid obesity affected signal detection in this same MDD study population [32]. We examined the effect size resulting from combining the moderating factor (morbid obesity) with the mediating factor of early QIDS-SR 16 treatment response.…”

Section: Signal Detection In Subjects With Morbid Obesity and < 50% Qmentioning

confidence: 93%

Early treatment response affects signal detection in a placebo-controlled depression study

Targum¹,

Catania²

2017

Personalized Medicine in Psychiatry

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We examined the effect of early treatment response on the Quick Inventory of Depressive Symptomatology (QIDS-SR 16) within 2 weeks following randomization on the eventual treatment outcome at 6 weeks in a doubleblind study of subjects with major depressive disorder randomly assigned to a combination treatment (buspirone 15 mg with melatonin SR 3 mg), buspirone 15 mg, or placebo (Clinicaltrials.org: NCT 007005003). The extent of QIDS-SR 16 score improvement between baseline and week 2 was significantly associated with higher treatment response rates at week 6 (≥50% QIDS-SR 16 improvement from baseline) regardless of treatment assignment. Thirty-two of 123 subjects (26.0%) were QIDS-SR 16 treatment responders by week 2 and were excluded in a post-hoc analysis of five clinical metrics: QIDS-SR 16 , the Inventory of Depressive Symptomatology (IDS-c30), clinical global impression of severity and improvement scales, and Hamilton rating scale for anxiety. The effect size favoring the combination-treatment over buspirone and/or placebo increased on each of the 5 clinical metrics in the remaining 91 subjects with < 50% QIDS-SR 16 improvement at week 2. For instance, the effect size favoring the combination treatment over the pooled buspirone and placebo groups improved from 0.33 in the mITT population to 0.64 for the QIDS-SR 16 , and from 0.37 to 0.58 for the IDS-c30. Further, the statistical significance favoring the combination treatment improved from p = .055-.017 for the QIDS-SR 16. This was a post-hoc analysis of a small MDD study, but it is clear that future studies need to explore the mediating factors that affect signal detection and influence individual treatment response.

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Section: Signal Detection In Subjects With Morbid Obesity and < 50% Qmentioning

confidence: 93%

Early treatment response affects signal detection in a placebo-controlled depression study

Targum¹,

Catania²

2017

Personalized Medicine in Psychiatry

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“…Studies have shown that different medications may be more effective for individuals with different levels of obesity, with escitalopram being more effective for individuals with a normal BMI, venlafaxine for those with obesity classes II and III, and bupropion-SSRIs for those with obesity class III (BMI ≥ 40 kg/m 2 ) [ 51 , 52 ]. However, morbid obesity (BMI ≥ 40 kg/m 2 ) may complicate drug response outcomes [ 53 ], suggesting the need for personalized treatment approaches.…”

Section: Mdd Stress and Neuropsychoimmunitymentioning

confidence: 99%

Personalized Medicine of Omega-3 Fatty Acids in Depression Treatment in Obese and Metabolically Dysregulated Patients

Chen

Chang

et al. 2023

JPM

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The co-occurrence of depression and obesity has become a significant public health concern worldwide. Recent studies have shown that metabolic dysfunction, which is commonly observed in obese individuals and is characterized by inflammation, insulin resistance, leptin resistance, and hypertension, is a critical risk factor for depression. This dysfunction may induce structural and functional changes in the brain, ultimately contributing to depression’s development. Given that obesity and depression mutually increase each other’s risk of development by 50–60%, there is a need for effective interventions that address both conditions. The comorbidity of depression with obesity and metabolic dysregulation is thought to be related to chronic low-grade inflammation, characterized by increased circulating levels of pro-inflammatory cytokines and C-reactive protein (CRP). As pharmacotherapy fails in at least 30–40% of cases to adequately treat major depressive disorder, a nutritional approach is emerging as a promising alternative. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are a promising dietary intervention that can reduce inflammatory biomarkers, particularly in patients with high levels of inflammation, including pregnant women with gestational diabetes, patients with type 2 diabetes mellitus, and overweight individuals with major depressive disorder. Further efforts directed at implementing these strategies in clinical practice could contribute to improved outcomes in patients with depression, comorbid obesity, and/or metabolic dysregulation.

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An augmentation study of MSI-195 (S-adenosylmethionine) in Major Depressive Disorder

Targum¹,

Cameron²,

Ferreira³

et al. 2018

Journal of Psychiatric Research

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Impact of morbid obesity on treatment outcome in a clinical trial of major depressive disorder

Cited by 3 publications

References 25 publications

Early treatment response affects signal detection in a placebo-controlled depression study

Early treatment response affects signal detection in a placebo-controlled depression study

Personalized Medicine of Omega-3 Fatty Acids in Depression Treatment in Obese and Metabolically Dysregulated Patients

An augmentation study of MSI-195 (S-adenosylmethionine) in Major Depressive Disorder

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