Sex differences in the prediction of the effectiveness of paroxetine for patients with major depressive disorder identified using a receiver operating characteristic curve analysis for early response

Abstract

BackgroundWe investigated cutoff values for the early response of patients with major depressive disorder to paroxetine and their sex differences by using a receiver operating characteristic (ROC) curve analysis to predict the effectiveness of paroxetine.MethodsIn total, 120 patients with major depressive disorder were enrolled and treated with 10–40 mg/day paroxetine for 6 weeks; 89 patients completed the protocol. A clinical evaluation using the Montgomery–Asberg Depression Rating Scale (MADRS) was performed at weeks 0, 1, 2, 4, and 6.ResultsIn male subjects, the cutoff values for MADRS improvement rating in week 1, week 2, and week 4 were 20.9%, 34.9%, and 33.3%, respectively. The sensitivities and the specificities were 83.3% and 80.0%, 83.3% and 80.0%, and 100% and 90%, respectively. The areas under the curve (AUC) were 0.908, 0.821, and 0.979, respectively. In female subjects, the cutoff values for the MADRS improvement rating in week 1, week 2, and week 4 were 21.4%, 35.7%, and 32.3%, respectively. The sensitivities and the specificities were 71.4% and 84.6%, 73.8% and 76.9%, and 90.5% and 76.9%, respectively. The AUCs were 0.781, 0.735, and 0.904, respectively.ConclusionEarly improvement with paroxetine may predict the long-term response. The accuracy of the prediction for the response is higher in male subjects.

The association between the subjective memory complaints scale and depressive state and cognitive impairment: a factor analysis

“…Many previous studies reported sex differences in the prevalence and characteristics of depressive state and cognitive impairment, and we previously reported sex differences in the association between the presence of SMCs and depressive symptoms and cognitive function and in the prediction of the effectiveness of treatment for patients with depression. 17 , 24 The investigation of the effects of sex might increase the importance of the present results. Fourth, the reliability of discriminating depressive state from cognitive impairment by Factors 1 and 2 is limited because the correlation coefficient between two factors was 0.587, and Factors 1 and 2 did not show significant associations with cognitive impairment.…”

“…We previously reported that the presence of SMCs influences depressive symptoms and cognitive functioning. 17 In the present study, we investigated the association between the items of the SMC scale and depressive state and cognitive impairment in community-dwelling people in Japan and identified the items that predict depression and cognitive impairment.…”

Effects of Age on Paroxetine Efficacy in Patients With Major Depressive Disorder Who Do Not Exhibit an Early Response to Treatment

“…[15][16][17] We may have identified additional results that are more important as well as useful information for clinical settings by studying the patients via other definitions of early response. First, the sample size was small, and the dropout rate was comparatively large in the study.…”

“…17 We also defined responders as those patients with MADRS improvements higher than 50% after 6 weeks of treatment compared with the baseline score. 17 We also defined responders as those patients with MADRS improvements higher than 50% after 6 weeks of treatment compared with the baseline score.…”

Does early improvement in depressive symptoms predict subsequent remission in patients with depression who are treated with duloxetine?

“…There are some previous reports focusing on the same field as ours, in which the number of patients included is ~100. 17 , 18 Although we decided sample size of this study according to those reports described, more appropriate approach for sample size determination should have been adopted.…”