Three new studies help predict which patients with depression may not respond to pharmacotherapy and which women may become depressed during menopause.
1. Mandelli L, Serretti A, Souery D, et al. High occupational level is associated with poor response to treatment of depression. Eur Neuropsychopharmacol. 2016;26:1320-1326.
2. Li QS, Tian C, Seabrook GR, et al. Analysis of 23andMe antidepressant efficacy survey data: implication of circadian rhythm and neuroplasticity in bupropion response. Transl Psychiatry. 2016;6:e889. doi:10.1038/tp.2016.171
3. Joffe H, Crawford SL, Freeman MP, et al. Independent contributions of nocturnal hot flashes and sleep disturbance to depression in estrogen-deprived women. J Clin Endocrinol Metab. 2016 Sep 28:jc20162348. [Epub ahead of print] doi.org/10.1210/jc.2016-2348
Three new studies help predict which patients with MDD may not respond to pharmacotherapy and which women may become depressed during menopause.[1-3] Scroll through the slides for the latest findings and take-home messages. To view the information in PDF format, click
1. Depressed Patients With High-Status Occupations Are Less Likely to Respond to Antidepressants:
Patients with major depression (N = 654) who had undergone at least 1 adequate antidepressant trial were stratified into high, middle, and low occupational levels. Depressed patients with high-status occupations, who had higher education levels, showed a significantly poorer response to the last treatment, with lower remission rates and more treatment resistance than those at other occupational levels. Also, they were less commonly treated with serotonin reuptake inhibitors..
Take-home message: Depressed patients with a high-level occupation, who may be subject to stress, may be at risk for a poor response to antidepressants. See: High occupational level is associated with poor response to treatment of depression
2. Response to Bupropion Is Less Likely in Patients With a Specific Genetic Variant: Using survey and genotype data from the genetic testing company 23andMe, researchers conducted a genome-wide association study. The most significant association found was from bupropion responders versus non-responders. Each copy of the rs1908557-C allele was associated with higher odds of not responding to bupropion. The frequency of C allele was relatively common (about 25%) in the study population.
If replicated with larger sample sizes, this could be a step toward predicting which patients with MDD respond to specific treatments. See:
Analysis of 23andMe antidepressant efficacy survey data: implication of circadian rhythm and neuroplasticity in bupropion
3. Nighttime Hot Flashes and Interrupted Sleep May Lead to Mild Depressive Symptoms in Menopausal Women: Twenty-nine healthy, premenopausal women took a gonadotropin-releasing hormone agonist to suppress ovarian estrogen production for 4 weeks to induce menopausal symptoms. Those women who reported frequent nighttime hot flashes were more likely to have mild symptoms of depression than those who reported fewer or no nighttime hot flashes. Daytime hot flashes had no effect on mood. Women who experienced sleep interruption also were more likely to exhibit symptoms of depression than those who got more sleep.
The results suggest that menopausal women who report nighttime hot flashes and sleep disruption should be screened for mood disturbances. See:
Independent contributions of nocturnal hot flashes and sleep disturbance to depression in estrogen-deprived women