Neuropsychological characteristics as predictors of SSRI treatment response in depressed subjects

J Neural Transm (Vienna). 2008 Aug;115(8):1213-9. doi: 10.1007/s00702-008-0084-x. Epub 2008 Jul 16.

Abstract

Studies suggest that neuropsychological measures may provide prognostic information regarding SSRI treatment response, yet it is unclear which specific cognitive domains are the most effectual predictors. The aim of this study was to characterize the cognitive profile associated with SSRI nonresponse using a comprehensive set of neuropsychological tests. Participants (N = 32) met criteria for current major depressive episode. Assessment followed pre-treatment medication washout. Clinical response was measured after 3-month open-label SSRI treatment. Groups did not differ by demographic characteristics, intelligence or depression severity. Responders outperformed nonresponders across all cognitive domains, with the largest differences observed in executive, language and working memory functions. Results indicate poorer global cognitive functioning is predictive of treatment nonresponse. Deficits were most pronounced in tests demanding greater mental search and manipulation rather than speeded motor output. Cognitive slowing may mediate the working memory and executive function deficits found in nonresponders. These findings can inform exploration for pharmacogenetic endophenotypes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / psychology*
  • Female
  • Fluoxetine / therapeutic use
  • Humans
  • Intelligence Tests
  • Male
  • Memory, Short-Term / drug effects
  • Multivariate Analysis
  • Neuropsychological Tests*
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Psychomotor Performance / drug effects
  • Psychomotor Performance / physiology
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Treatment Outcome

Substances

  • Serotonin Uptake Inhibitors
  • Fluoxetine