Residual Depressive Symptoms in Responders to Citalopram

Depressed patients who respond to citalopram but don't remit report residual depressive symptoms

MONDAY, May 9 (HealthDay News) -- Patients with major depressive disorder (MDD) who respond to citalopram but do not remit report a range of residual domains and depressive symptoms, according to a study published in the April issue of the Journal of Clinical Psychopharmacology.

Shawn M. McClintock, Ph.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues investigated the residual domains and individual depressive symptoms in a large sample of outpatients with nonpsychotic MDD who responded to treatment of up to 12 weeks of citalopram without remitting. Response was defined as a 50 percent or greater reduction in baseline 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16) by the completion of treatment, and remission was defined as a final QIDS-SR16 score lower than six. Residual domains and individual symptoms were classified as persisting from baseline or developing during treatment.

The investigators found that most responders who did not remit reported five domains, most commonly insomnia, sad mood, and decreased concentration. They also reported six to seven residual depressive symptoms, most frequently midnocturnal insomnia and decreased general interest. The most frequent lasting symptoms were midnocturnal insomnia, sad mood, and decreased concentration or decision making. The least common persistent residual and treatment emergent symptom was suicidal ideation.

"Patients with nonpsychotic MDD who achieved response but not remission with citalopram experienced substantial residual depressive symptoms," the authors write. "It seems important to differentiate symptoms that emerge during treatment from those that persist from baseline to exit, as this distinction may well have implications for guiding treatment."

Several of the study authors disclosed financial ties to the pharmaceutical industry.

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