Assessing rates and predictors of tachyphylaxis during the prevention of recurrent episodes of depression with venlafaxine ER for two years (PREVENT) study

Anthony J. Rothschild, Boadie W. Dunlop, David L. Dunner, Edward S. Friedman, Alan Gelenberg, Peter Holland, James H. Kocsis, Susan G. Kornstein, Richard Shelton, Madhukar H. Trivedi, John M. Zajecka, Corey Goldstein, Michael E. Thase, Ron Pedersen, Martin B. Keller

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Antidepressant tachyphylaxis describes the return of apathetic depressive symptoms, such as fatigue and decreased motivation, despite continued use of a previously effective treatment. Methods: Data were collected from a multiphase, double-blind, placebo-controlled study that assessed the efficacy of venlafaxine extended release (ER) during 2 sequential 1-year maintenance phases (A and B) in patients with recurrent major depressive disorder (MDD). The primary outcome was the cumulative probability of tachyphylaxis in patients receiving venlafaxine ER, fluoxetine, or placebo. Tachyphylaxis was defined as Rothschild Scale for Antidepressant Tachyphylaxis (RSAT) score ≥ 7 in patients with prior satisfactory therapeutic response. A Kaplan-Meier estimate of the cumulative probability of not experiencing tachyphylaxis, and a 2-sided Fisher exact test was used to assess the relationship between tachyphylaxis and recurrence. Results: The maintenance phase A population was comprised of 337 patients (venlafaxine ER [n = 129], fluoxetine [n = 79], placebo [n = 129]), whereas 128 patients (venlafaxine ER [n = 43], fluoxetine [n = 45], placebo [n = 40]) were tre a ted during maintenance phase B. No difference in the probability of experiencing tachyphylaxis were observed between the active treatment groups during either maintenance phase; however, a significant difference between venlafaxine ER and placebo was observed at the completion of maintenance phase A. A significant relationship between tachyphylaxis and recurrence was observed. Limitations: Despite demonstrating psychometric validity and reliability, the current definition of tachyphylaxis has not been widely studied. Conclusions: Although no significant differences were observed in the probability of tachyphylaxis among patients receiving active treatment, the relationship between tachyphylaxis and recurrence suggests that tachyphylaxis may be a prodrome of recurrence.

Original languageEnglish (US)
Pages (from-to)5-20
Number of pages16
JournalPsychopharmacology Bulletin
Volume42
Issue number3
StatePublished - 2009

Fingerprint

Tachyphylaxis
Depression
Placebos
Maintenance
Fluoxetine
Recurrence
Antidepressive Agents
Venlafaxine Hydrochloride
Major Depressive Disorder
Kaplan-Meier Estimate
Therapeutics
Psychometrics
Reproducibility of Results
Fatigue
Motivation

Keywords

  • Loss of antidepressant response
  • Major depressive disorder
  • Psychopharmacology
  • Rothschild scale for antidepressant
  • Serotonin norepinephrine reuptake inhibitor

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Rothschild, A. J., Dunlop, B. W., Dunner, D. L., Friedman, E. S., Gelenberg, A., Holland, P., ... Keller, M. B. (2009). Assessing rates and predictors of tachyphylaxis during the prevention of recurrent episodes of depression with venlafaxine ER for two years (PREVENT) study. Psychopharmacology Bulletin, 42(3), 5-20.

Assessing rates and predictors of tachyphylaxis during the prevention of recurrent episodes of depression with venlafaxine ER for two years (PREVENT) study. / Rothschild, Anthony J.; Dunlop, Boadie W.; Dunner, David L.; Friedman, Edward S.; Gelenberg, Alan; Holland, Peter; Kocsis, James H.; Kornstein, Susan G.; Shelton, Richard; Trivedi, Madhukar H.; Zajecka, John M.; Goldstein, Corey; Thase, Michael E.; Pedersen, Ron; Keller, Martin B.

In: Psychopharmacology Bulletin, Vol. 42, No. 3, 2009, p. 5-20.

Research output: Contribution to journalArticle

Rothschild, AJ, Dunlop, BW, Dunner, DL, Friedman, ES, Gelenberg, A, Holland, P, Kocsis, JH, Kornstein, SG, Shelton, R, Trivedi, MH, Zajecka, JM, Goldstein, C, Thase, ME, Pedersen, R & Keller, MB 2009, 'Assessing rates and predictors of tachyphylaxis during the prevention of recurrent episodes of depression with venlafaxine ER for two years (PREVENT) study', Psychopharmacology Bulletin, vol. 42, no. 3, pp. 5-20.
Rothschild, Anthony J. ; Dunlop, Boadie W. ; Dunner, David L. ; Friedman, Edward S. ; Gelenberg, Alan ; Holland, Peter ; Kocsis, James H. ; Kornstein, Susan G. ; Shelton, Richard ; Trivedi, Madhukar H. ; Zajecka, John M. ; Goldstein, Corey ; Thase, Michael E. ; Pedersen, Ron ; Keller, Martin B. / Assessing rates and predictors of tachyphylaxis during the prevention of recurrent episodes of depression with venlafaxine ER for two years (PREVENT) study. In: Psychopharmacology Bulletin. 2009 ; Vol. 42, No. 3. pp. 5-20.
@article{3a5a097926ec43879bad5fb8696dc561,
title = "Assessing rates and predictors of tachyphylaxis during the prevention of recurrent episodes of depression with venlafaxine ER for two years (PREVENT) study",
abstract = "Background: Antidepressant tachyphylaxis describes the return of apathetic depressive symptoms, such as fatigue and decreased motivation, despite continued use of a previously effective treatment. Methods: Data were collected from a multiphase, double-blind, placebo-controlled study that assessed the efficacy of venlafaxine extended release (ER) during 2 sequential 1-year maintenance phases (A and B) in patients with recurrent major depressive disorder (MDD). The primary outcome was the cumulative probability of tachyphylaxis in patients receiving venlafaxine ER, fluoxetine, or placebo. Tachyphylaxis was defined as Rothschild Scale for Antidepressant Tachyphylaxis (RSAT) score ≥ 7 in patients with prior satisfactory therapeutic response. A Kaplan-Meier estimate of the cumulative probability of not experiencing tachyphylaxis, and a 2-sided Fisher exact test was used to assess the relationship between tachyphylaxis and recurrence. Results: The maintenance phase A population was comprised of 337 patients (venlafaxine ER [n = 129], fluoxetine [n = 79], placebo [n = 129]), whereas 128 patients (venlafaxine ER [n = 43], fluoxetine [n = 45], placebo [n = 40]) were tre a ted during maintenance phase B. No difference in the probability of experiencing tachyphylaxis were observed between the active treatment groups during either maintenance phase; however, a significant difference between venlafaxine ER and placebo was observed at the completion of maintenance phase A. A significant relationship between tachyphylaxis and recurrence was observed. Limitations: Despite demonstrating psychometric validity and reliability, the current definition of tachyphylaxis has not been widely studied. Conclusions: Although no significant differences were observed in the probability of tachyphylaxis among patients receiving active treatment, the relationship between tachyphylaxis and recurrence suggests that tachyphylaxis may be a prodrome of recurrence.",
keywords = "Loss of antidepressant response, Major depressive disorder, Psychopharmacology, Rothschild scale for antidepressant, Serotonin norepinephrine reuptake inhibitor",
author = "Rothschild, {Anthony J.} and Dunlop, {Boadie W.} and Dunner, {David L.} and Friedman, {Edward S.} and Alan Gelenberg and Peter Holland and Kocsis, {James H.} and Kornstein, {Susan G.} and Richard Shelton and Trivedi, {Madhukar H.} and Zajecka, {John M.} and Corey Goldstein and Thase, {Michael E.} and Ron Pedersen and Keller, {Martin B.}",
year = "2009",
language = "English (US)",
volume = "42",
pages = "5--20",
journal = "Psychopharmacology Bulletin",
issn = "0048-5764",
publisher = "MedWorks Media LLC",
number = "3",

}

TY - JOUR

T1 - Assessing rates and predictors of tachyphylaxis during the prevention of recurrent episodes of depression with venlafaxine ER for two years (PREVENT) study

AU - Rothschild, Anthony J.

AU - Dunlop, Boadie W.

AU - Dunner, David L.

AU - Friedman, Edward S.

AU - Gelenberg, Alan

AU - Holland, Peter

AU - Kocsis, James H.

AU - Kornstein, Susan G.

AU - Shelton, Richard

AU - Trivedi, Madhukar H.

AU - Zajecka, John M.

AU - Goldstein, Corey

AU - Thase, Michael E.

AU - Pedersen, Ron

AU - Keller, Martin B.

PY - 2009

Y1 - 2009

N2 - Background: Antidepressant tachyphylaxis describes the return of apathetic depressive symptoms, such as fatigue and decreased motivation, despite continued use of a previously effective treatment. Methods: Data were collected from a multiphase, double-blind, placebo-controlled study that assessed the efficacy of venlafaxine extended release (ER) during 2 sequential 1-year maintenance phases (A and B) in patients with recurrent major depressive disorder (MDD). The primary outcome was the cumulative probability of tachyphylaxis in patients receiving venlafaxine ER, fluoxetine, or placebo. Tachyphylaxis was defined as Rothschild Scale for Antidepressant Tachyphylaxis (RSAT) score ≥ 7 in patients with prior satisfactory therapeutic response. A Kaplan-Meier estimate of the cumulative probability of not experiencing tachyphylaxis, and a 2-sided Fisher exact test was used to assess the relationship between tachyphylaxis and recurrence. Results: The maintenance phase A population was comprised of 337 patients (venlafaxine ER [n = 129], fluoxetine [n = 79], placebo [n = 129]), whereas 128 patients (venlafaxine ER [n = 43], fluoxetine [n = 45], placebo [n = 40]) were tre a ted during maintenance phase B. No difference in the probability of experiencing tachyphylaxis were observed between the active treatment groups during either maintenance phase; however, a significant difference between venlafaxine ER and placebo was observed at the completion of maintenance phase A. A significant relationship between tachyphylaxis and recurrence was observed. Limitations: Despite demonstrating psychometric validity and reliability, the current definition of tachyphylaxis has not been widely studied. Conclusions: Although no significant differences were observed in the probability of tachyphylaxis among patients receiving active treatment, the relationship between tachyphylaxis and recurrence suggests that tachyphylaxis may be a prodrome of recurrence.

AB - Background: Antidepressant tachyphylaxis describes the return of apathetic depressive symptoms, such as fatigue and decreased motivation, despite continued use of a previously effective treatment. Methods: Data were collected from a multiphase, double-blind, placebo-controlled study that assessed the efficacy of venlafaxine extended release (ER) during 2 sequential 1-year maintenance phases (A and B) in patients with recurrent major depressive disorder (MDD). The primary outcome was the cumulative probability of tachyphylaxis in patients receiving venlafaxine ER, fluoxetine, or placebo. Tachyphylaxis was defined as Rothschild Scale for Antidepressant Tachyphylaxis (RSAT) score ≥ 7 in patients with prior satisfactory therapeutic response. A Kaplan-Meier estimate of the cumulative probability of not experiencing tachyphylaxis, and a 2-sided Fisher exact test was used to assess the relationship between tachyphylaxis and recurrence. Results: The maintenance phase A population was comprised of 337 patients (venlafaxine ER [n = 129], fluoxetine [n = 79], placebo [n = 129]), whereas 128 patients (venlafaxine ER [n = 43], fluoxetine [n = 45], placebo [n = 40]) were tre a ted during maintenance phase B. No difference in the probability of experiencing tachyphylaxis were observed between the active treatment groups during either maintenance phase; however, a significant difference between venlafaxine ER and placebo was observed at the completion of maintenance phase A. A significant relationship between tachyphylaxis and recurrence was observed. Limitations: Despite demonstrating psychometric validity and reliability, the current definition of tachyphylaxis has not been widely studied. Conclusions: Although no significant differences were observed in the probability of tachyphylaxis among patients receiving active treatment, the relationship between tachyphylaxis and recurrence suggests that tachyphylaxis may be a prodrome of recurrence.

KW - Loss of antidepressant response

KW - Major depressive disorder

KW - Psychopharmacology

KW - Rothschild scale for antidepressant

KW - Serotonin norepinephrine reuptake inhibitor

UR - http://www.scopus.com/inward/record.url?scp=77952963486&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952963486&partnerID=8YFLogxK

M3 - Article

C2 - 19752838

AN - SCOPUS:77952963486

VL - 42

SP - 5

EP - 20

JO - Psychopharmacology Bulletin

JF - Psychopharmacology Bulletin

SN - 0048-5764

IS - 3

ER -