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Citalopram amplifies the influence of living conditions on mood in depressed patients enrolled in the STARD study

Chiarotti, F ; Viglione, A ; Giuliani, A ; Branchi, I

Translational psychiatry, 2017-03, Vol.7 (3), p.e1066-e1066 [Periódico revisado por pares]

United States: Nature Publishing Group

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  • Título:
    Citalopram amplifies the influence of living conditions on mood in depressed patients enrolled in the STARD study
  • Autor: Chiarotti, F ; Viglione, A ; Giuliani, A ; Branchi, I
  • Assuntos: Adolescent ; Adult ; Affect ; Aged ; Antidepressive Agents - therapeutic use ; Citalopram - therapeutic use ; Depressive Disorder, Major - drug therapy ; Depressive Disorder, Major - psychology ; Educational Status ; Employment ; Female ; Humans ; Income ; Insurance, Health ; Male ; Middle Aged ; Original ; Prognosis ; Randomized Controlled Trials as Topic ; Remission Induction ; Social Conditions ; Treatment Outcome ; Young Adult
  • É parte de: Translational psychiatry, 2017-03, Vol.7 (3), p.e1066-e1066
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
    These authors contributed equally as first-author.
  • Descrição: Selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed antidepressant drugs, have a variable and incomplete efficacy. In order to better understand SSRI action, we explored the hypothesis that SSRIs do not affect mood per se but amplify the influence of the living conditions on mood. To this aim, we exploited the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) data set, selected a subpopulation of 591 patients with an overlapping clinical history and analyzed treatment outcome according to dosage -20 or 40 mg per day of citalopram. We found that sociodemographic characteristics affected treatment response in the same direction in the two dose groups, but these effects reached statistical significance only in the 40 mg per day dose group. In the latter, higher improvement rate was associated with having a working employment status (P=0.0219), longer education (P=0.0053), high income (P=0.01) or a private insurance (P=0.0031), and the higher remission rate was associated with having a working employment status (P=0.0326) or longer education (P=0.0484). Moreover, the magnitude of the effect of the sociodemographic characteristics on mood, measured as the percent of patients showing a positive outcome when exposed to favorable living conditions, was much greater-up to 37-fold-in the 40 compared to the 20 mg per day dose group. Overall, our results indicate that citalopram amplifies the influence of the living conditions on mood in a dose-dependent manner. These findings provide a potential explanation for the variable efficacy of SSRIs and might lead to the development of personalized strategies aimed at enhancing their efficacy.
  • Editor: United States: Nature Publishing Group
  • Idioma: Inglês
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