RESEARCH – November 2006

Factors predicting outcome of treatment with selective serotonin re-uptake inhibitors


Articles PDF


Introduction. Selective serotonin re-uptake inhibitors (SSRIs) are more popular and prefered firstline drugs in treatment of mood and anxiety disorders compared with old antidepressants because of their better tolerance and higher safety. Nevertheless, it is rather difficult in clinical practice to predict which patient will respond well to pharmacological treatment and which will not. Recently, we aimed to clarify which demographic and clinical characteristics may predict treatment responses to SSRIs.
Methods. In two naturalistic open-label studies 123 patients were treated with citalopram (4 weeks 20 mg/day) and 222 patients were treated with paroxetine (8 weeks 20-40 mg/day). Variables from the following prospective predictors were included in our studies: demographic characteristics (age, gender, education,  and marital status) and illness-related variables (severity of depressive symptoms, melancholia, coexisting anxiety, number and duration of previous episodes, somatic disorders, heritability, suicidal behaviour).
Results. None of studied clinical or sociodemographic factors predicted the response to citalopram. However, we found that some clinical aspects, such as severity of depression and insomnia, may predict the response to paroxetine treatment.
Conclusion. In agreement with previous findings our results suggest that clinical assessment or even clinical patterns are difficult apply when selecting antidepressants, but there is an urgent need for substantial optimization and improvement of outcome of pharmacotherapy in the case of psychiatric disorders by providing individualized and science-based treatment guidelines.