Modeling the Recovery from Depressive Illness by an Exponential Model with Mixed Effects

Friede, Tim; Kieser, Meinhard; Miller, Frederick N.

doi:10.1055/s-0038-1634261

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Recent work by Priest et al [23] and by Friede et al [9] has shown that the time course of the HAMD total score during recovery from depression can be described by fitting an exponential regression model to the data. While such models can describe the data actually observed during a trial, they may also be used to predict the future recovery process beyond the end of the period of observation.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…While such models can describe the data actually observed during a trial, they may also be used to predict the future recovery process beyond the end of the period of observation. For our trial, exponential recovery curves were determined, which showed a good model fit to the observed treatment group means (for details, see [9]). The Hypericum groups recovery curve was substantially steeper, indicating a faster HAMD total score decrease.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

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Efficacy and Tolerability of Hypericum Extract WS 5572 versus Placebo in Mildly to Moderately Depressed Patients - A randomized double-blind multicenter clinical trial -

Kalb

Trautmann-Sponsel²,

Kieser³

2001

Pharmacopsychiatry

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We have investigated the antidepressant efficacy and safety of Hypericum perforatum (St. John's wort) extract WS5572 in a double-blind, placebo-controlled multicenter clinical trial. 72 patients (WS 5572: 37, placebo: 35) with a diagnosis of mild to moderate major depressive disorder (according to DSM-IV criteria) were randomized in 42 days of treatment with either 300 mg WS5572 t.i.d. or placebo. The primary efficacy variable was the change of the 17-item Hamilton Depression Scale (HAMD) total score between baseline and double-blind treatment. The study was conducted with an adaptive interim analysis, which led to early stopping because convincing treatment efficacy could already be demonstrated. Group differences in favor of WS 5572 were descriptively apparent as early as day 7 of randomized treatment and were statistically significant at days 28 (p = 0.011) and day 42 (p < 0.001). Between baseline and treatment end, the HAMD total score decreased from 19.7 +/- 3.4 to 8.9 +/- 4.3 points in the Hypericum group and from 20.1 +/- 2.6 to 14.4 +/- 6.8 points in the placebo group (mean +/- SD). Responder rates were consistently higher in the Hypericum group. Comparable group differences in favor of WS 5572 were also found for von Zerssen's Depression Scale (D-S; self-rating), Clinical Global Impressions (CGI) and a global patient's self-assessment (GPA). Tolerability was very good in both groups, with no adverse drug reactions and no clinically relevant changes in safety parameters. The results indicate that Hypericum extract WS 5572 is an effective and well-tolerated drug for the treatment of mild to moderate major depressive disorder.

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Section: Baseline Characteristicsmentioning

confidence: 99%

Section: Baseline Characteristicsmentioning

confidence: 99%

Efficacy and Tolerability of Hypericum Extract WS 5572 versus Placebo in Mildly to Moderately Depressed Patients - A randomized double-blind multicenter clinical trial -

Kalb

Trautmann-Sponsel²,

Kieser³

2001

Pharmacopsychiatry

Self Cite

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show abstract

“…However, probably most important of all from a clinical point of view, the figure also shows that in both dimensions the difference between Hypericum extract and placebo increased over time: while the response curves of the patients treated with placebo tended to flat out between treatment days 14 and 42, this was not the case in the Hypericum group. Priest and colleagues (1996; see also Friede et al 2000) have demonstrated with reference to the time course of the HAMD total score that recovery from depression can be described by fitting an exponential model. By extrapolating the time courses in Fig.…”

Section: Discussionmentioning

confidence: 97%

Cluster analysis of symptoms during antidepressant treatment with Hypericum extract in mildly to moderately depressed out-patients. A meta-analysis of data from three randomized, placebo-controlled trials

Kasper

Dienel

2002

Psychopharmacology

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“…Pharmacological antidepressant treatments have been shown to exhibit a nonlinear pattern of treatment response, with relatively large improvements in symptoms in the first weeks followed by smaller but continued improvements approaching a plateau 19 – 21 . This decrease in depressive symptoms has been modeled using an exponential decay function across multiple medications 22 – 24 . The exponential decay model suggests a defined relationship between early clinical response and eventual treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Modeling the antidepressant treatment response to transcranial magnetic stimulation using an exponential decay function

Berlow

Zandvakili

Brennan

et al. 2023

Sci Rep

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Recovery from depression often demonstrates a nonlinear pattern of treatment response, where the largest reduction in symptoms is observed early followed by smaller improvements. This study investigated whether this exponential pattern could model the antidepressant response to repetitive transcranial magnetic stimulation (TMS). Symptom ratings from 97 patients treated with TMS for depression were collected at baseline and after every five sessions. A nonlinear mixed-effects model was constructed using an exponential decay function. This model was also applied to group-level data from several published clinical trials of TMS for treatment-resistant depression. These nonlinear models were compared to corresponding linear models. In our clinical sample, response to TMS was well modeled with the exponential decay function, yielding significant estimates for all parameters and demonstrating superior fit compared to a linear model. Similarly, when applied to multiple studies comparing TMS modalities as well as to previously identified treatment response trajectories, the exponential decay models yielded consistently better fits compared to linear models. These results demonstrate that the antidepressant response to TMS follows a nonlinear pattern of improvement that is well modeled with an exponential decay function. This modeling offers a simple and useful framework to inform clinical decisions and future studies.

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Modeling the Recovery from Depressive Illness by an Exponential Model with Mixed Effects

Cited by 7 publications

References 8 publications

Efficacy and Tolerability of Hypericum Extract WS 5572 versus Placebo in Mildly to Moderately Depressed Patients - A randomized double-blind multicenter clinical trial -

Efficacy and Tolerability of Hypericum Extract WS 5572 versus Placebo in Mildly to Moderately Depressed Patients - A randomized double-blind multicenter clinical trial -

Cluster analysis of symptoms during antidepressant treatment with Hypericum extract in mildly to moderately depressed out-patients. A meta-analysis of data from three randomized, placebo-controlled trials

Modeling the antidepressant treatment response to transcranial magnetic stimulation using an exponential decay function

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