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Stassen

Fakultäten » Medizinische Fakultät » Psychiatrische Universitätsklinik » Psychiatrie, Psychotherapie und Psychosomatik, Klinik für » Prof. Dr. Daniel Hell (emeritiert) » Stassen

Completed research project

Title / Titel A Molecular-Genetic Approach to Detailing Onset of Action of Antidepressants
PDF Abstract (PDF, 14 KB)
Summary / Zusammenfassung Timing issues of antidepressant and antipsychotic drug response are of major clinical relevance, given our current inability to predict when a particular patient will respond to a particular treatment. We detailed the time characteristics of recovery in a study on 2’788 patients treated with 7 different antidepressants and placebo. A two-dimensional cure model was used to disentangle the two central aspects of psychotropic drug response, the proportion of patients in whom a therapeutic response is induced (“incidence”) and the time to onset of improvement (“latency”). Our analyses yielded no indication for a delayed onset of antidepressant drug response. Rather, we found highly individual time characteristics of recovery along with a continuous distribution of the time spans to onset of improvement under all active compounds and placebo. Effective antidepressants appeared to trigger and maintain conditions necessary for recovery from the disorder. Therefore, affectively ill patients are likely to possess a common biological, “resilience”-like component that largely controls recovery from depression. Once triggered, recovery follows a pattern similar to the course observed under placebo, despite marked pharmacological differences of the triggers. Our recent molecular-genetic pilot study of 257 patients and 178 candidate genes yielded highly significant correlations between the time point of onset of improvement and a 23-dimensional genotype. This finding is currently being verified through a study of 640 patients.
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Publications / Publikationen
Lavergne F, Berlin I, Gamma A, Stassen H, Angst J: Onset of improvement and response to mirtazapine in depression: a multicenter naturalistic study of 4771 patients. Neuropsychiatric Disease and Treatment 2005; 1(1): 59-68

Szegedi A, Rujescu D, Tadic A, Mueller MJ, Kohnen R, Stassen HH, Dahmen N: The catechol-O-methyltransferase Val108/158Met-polymorphism affects short-term treatment response to mirtazapine, but not to paroxetine in Major Depression. Pharmacogenomics 2005; 5(1): 49-53

Stassen HH, Angst J, Scharfetter C, Szegedi A: Therapie mit Antidepressiva: Erfolg von genetischen Faktoren abhängig? Leading Opinions, Neurologie & Psychiatrie 2005; 6: 25-27

Tadic A, Muller MJ, Rujescu D, Kohnen R, Stassen HH, Dahmen N, Szegedi A: The MAOA T941G polymorphism and short-term treatment response to mirtazapine and paroxetine in major depression. Am J Med Genet B Neuropsychiatr Genet. 2007; 144(3): 325-331

Stassen HH, Angst J, Scharfetter C, Szegedi A: What lets patients under antidepressants get stuck in their recovery after initial improvement? Eur Neuropsychopharmacol. 2007; 17 (Suppl. 4): S344-345

Tadic A, Rujescu D, Muller MJ, Kohnen R, Stassen HH, Dahmen N, Szegedi A: A monoamine oxidase B gene variant and short-term antidepressant treatment response. Prog Neuropsychopharmacol Biol Psychiatry. 2007; 31(7): 1370-1377

Stassen HH, Angst J, Hell D, Scharfetter C, Szegedi A: Is there a common resilience mechanism underlying antidepressant drug response? Evidence from 2848 patients. J Clin Psychiatry 2007; 68(8): 1195-1205

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Keywords / Suchbegriffe Antidepressants, response, onset of action, time course of improvement, molecular genetics
Project leadership and contacts /
Projektleitung und Kontakte
Prof. Dr. Hans H. Stassen (Project Leader) k454910@bli.uzh.ch
Prof. Dr. med. A. Szegedi  
PD Dr. T. Sander  
PD Dr. N. Dahmen  
Funding source(s) /
Unterstützt durch
SNF (Personen- und Projektförderung)
 
In collaboration with /
In Zusammenarbeit mit
PD Dr. T. Sander
Max-Delbruck Center for Molecular Medicine
Robert Roessle Str. 10
D-13092 Berlin
Germany
Duration of Project / Projektdauer Jun 2005 to Jun 2010