Factors Associated with Improvement in the Severity of Major Depressive Disorder 5 to 11 Weeks after Initiating Treatment with Antidepressants

Lortrakul J; Wannarit K; Pukrittayakamee P; Saisavoey N; Chantakarn S

Authors

Lortrakul J Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand
Wannarit K Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand
Pukrittayakamee P Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand
Saisavoey N Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand
Chantakarn S Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand

Keywords:

early remission, symptom improvement, major depressive disorder, MDD

Abstract

Objectives To identify factors associated with symptom improvement in patients with major depressive disorder (MDD) at 5 to 11 weeks after initiating treatment with antidepressants. Methods This observational clinical research study was based on data from a retrospective chart review. The patient population included individuals treated at the outpatient unit of the Department of Psychiatry of Siriraj Hospital (Bangkok, Thailand) who had been diagnosed for the first time with MDD according to criteria in the Diagnostic & Statistical Manual of Mental Disorders, 5th edition either by a psychiatrist or by a psychiatric resident under the supervision of a psychiatrist. Patient symptom severity was evaluated at the first visit using the Thai version of the Mont- gomery and Asberg Depression Rating Scale (MADRS) and was reevaluated 5 to 11 weeks after initiation of treatment.

Results The mean age of the 114 patients was 37.56±16.131 years and the majority (n=84 or 73.7%) were female. Treatment with an adequate dose of an anti-depressant for an sufficient period of time (> 5 weeks) (OR, 15.344; 95% CI, 1.756-134.119; p = 0.014) was associated with early remission of symptoms. Anti-depressant use at an adequate dose and for a sufficient period of time (OR 9.224; 95% CI 1.786-47.632; p = 0.008) was associated with symptom response.

Conclusion Use of an appropriate anti-depressant for at least 5 weeks is associated with early remission of depressive symptoms. Titrating antidepressants to an adequate dose and encouraging patients to continue their use for an adequate period can help improve treatment outcomes including MADRS scores.

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