Is response to antidepressant related to severity of symptoms? That was one of the questions posed by a meta-analysis published in JAMA Psychiatry.
The analysis of 87 randomised placebo-controlled trials (17,540 unique participants) examined the association of variability in response to antidepressants with severity of major depressive disorder, antidepressant class, or year of study publication.
The data showed that there was significantly more variability in response to antidepressants than to placebo (coefficients of variation [CV] ratio 1.14; 95% CI 1.11-1.17; P<.001>
Baseline severity of depression did not moderate variability in response.
Variability in response to selective serotonin reuptake inhibitors (SSRIs) was lower than that seen with noradrenergic agents (CV ratio 0.88; 95% CI 0.80-0.97; P=.01). Variability in response to other antidepressants vs noradrenergic agents was similar (CV ratio 0.87; 95% CI 0.79-0.97; P=.001).
Variability tended to be lower in more recent studies (CV ratio per year 0.005; 95% CI 0.002-0.008; P=.003).
The authors say the findings provide “empirical support for identifying moderators and personalising antidepressant treatment”.