Prediction of Tricyclic Antidepressant Response

Involvement of the Endocannabinoid System in the Ability of Long-Term Tricyclic Antidepressant Treatment to Suppress Stress-Induced Activation of the Hypothalamic–Pituitary–Adrenal Axis

“…These data also support the suggestion that the endocannabinoid system could serve as a suitable target for the development of novel antidepressants (Hill and Gorzalka, 2005a;Jiang et al, 2005;Gobbi et al, 2005), especially for melancholic depression , which exhibits a preferential response to tricyclic antidepressants and reliably exhibits hyperactivity of the HPA axis (Rush and Weissenburger, 1994;Bielski and Friedel, 1976;Gold and Chrousos, 2002).…”

Do age of onset and course of illness define biologically distinct groups within atypical depression?

“…That both groups' perceptual asymmetry differed significantly from healthy controls, but in opposite directions, seems most consistent with the two groups having different abnormalities in perceptual processing, rather than lying on a continuum from normal to abnormal. Further, the later onset or nonchronic patients share course of illness (i.e., later onset, Parker et al, 2001; and less chronic course, Kendler et al, 1996), treatment response (i.e., relatively high likelihood of responding to tricyclic antidepressants: Bielski & Friedel, 1976;Joyce & Paykel, 1989), and perceptual asymmetry (i.e., relative favoring of left-over right-hemisphere auditory processing: Bruder et al, 1989Bruder et al, , 2002 with melancholic patients, whereas the early onset, chronic atypical group differs from both melancholic patients and the later onset, nonchronic group on all of these dimensions. Thus, the later onset or nonchronic patients with atypical depression appear to have more in common with melancholic patients than with early onset, very chronic patients with atypical depression.…”

Do Age of Onset and Course of Illness Predict Different Treatment Outcome among DSM IV Depressive Disorders with Atypical Features?

“…There have been no recent reviews of predictors of response to second generation antidepressants, and older reviews found virtually no predictors other than the general view that patients with endogenous features respond best to TCA medications (Bielski and Friedel 1976;Joyce and Paykel 1990). Chronicity has generally been found to predict lower response rates to placebo (Khan et al 1991), and severity of illness predicts greater drug-placebo differences (Brown 1994).…”

“…Thus, if depressive subtypes respond differently to the same antidepressant medication, presumably some biologic difference accounts for this. Thus, depressed patients with endogenous symptoms can be expected to respond to TCAs (Bielski and Friedel 1976;Joyce and Paykel 1990), whereas those with atypical features are relatively less likely to respond to TCAs Quitkin et al 1990;Sotsky and Simmons 1999). Thase et al (1995) argued that these differences imply that depression with atypical features has a different biological basis than does "classical" depression.…”