Effectiveness of a quantitative electroencephalographic biomarker for predicting differential response or remission with escitalopram and bupropion in major depressive disorder

Andrew F. Leuchter, Ian A. Cook, William S. Gilmer, Lauren B. Marangell, Karl S. Burgoyne, Robert H. Howland, Madhukar H. Trivedi, Sidney Zisook, Rakesh Jain, Maurizio Fava, Dan Iosifescu, Scott Greenwald

Research output: Contribution to journalArticlepeer-review

97 Scopus citations

Abstract

We examined the Antidepressant Treatment Response (ATR) index as a predictor of differential response and remission to escitalopram, bupropion, or a combination of the two medications, in subjects with major depressive disorder (MDD). Three hundred seventy-five subjects had a baseline quantitative electroencephalographic (QEEG) study preceding 1 week of treatment with escitalopram, 10 mg, after which a second QEEG was performed and the ATR index was calculated. Subjects then were randomized to continue escitalopram, switch to bupropion, or receive a combination of the two. Clinical response was assessed using the 17-item Hamilton Depression Rating Scale at 49 days of treatment. Accuracy of ATR in predicting response and remission was calculated. There were no significant differences between response and remission rates in the three treatment groups. A single ATR threshold was useful for predicting differential response to either escitalopram or bupropion monotherapy. Subjects with ATR values above the threshold were more than 2.4 times as likely to respond to escitalopram as those with low ATR values (68% vs. 28%). Subjects with ATR values below the threshold who were switched to bupropion treatment were 1.9 times as likely to respond to bupropion alone as those who remained on escitalopram treatment (53% vs. 28%). The ATR index did not provide a useful prediction of response to combination treatment. The ATR index may prove useful in predicting responsiveness to different antidepressant medications.

Original languageEnglish (US)
Pages (from-to)132-138
Number of pages7
JournalPsychiatry research
Volume169
Issue number2
DOIs
StatePublished - Sep 30 2009

Keywords

  • Antidepressant treatment response (ATR) index
  • Bupropion
  • Differential medication response
  • Escitalopram
  • Major depression
  • Quantitative electroencephalography

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Fingerprint Dive into the research topics of 'Effectiveness of a quantitative electroencephalographic biomarker for predicting differential response or remission with escitalopram and bupropion in major depressive disorder'. Together they form a unique fingerprint.

Cite this