Adiponectin moderates antidepressant treatment outcome in the combining medications to enhance depression outcomes randomized clinical trial
| Autor: | Philipp E. Scherer, Brittany L. Mason, Thomas J. Carmody, Abigail A. Soyombo, Jennifer L. Furman, Madhukar H. Trivedi, Manish K. Jha, Andrew H. Czysz |
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| Rok vydání: | 2018 |
| Předmět: |
Oncology
medicine.medical_specialty Mirtazapine Venlafaxine Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine mental disorders medicine Escitalopram Bupropion Adiponectin business.industry medicine.disease 030227 psychiatry Psychiatry and Mental health Clinical Psychology Major depressive disorder Antidepressant Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Personalized Medicine in Psychiatry. :1-7 |
| ISSN: | 2468-1717 |
| Popis: | Background Major depressive disorder (MDD) is often comorbid with metabolic diseases such as obesity, cardiovascular disease, and type 2 diabetes. A potential link between these disorders is adiponectin, an adipocyte-derived circulating hormone with insulin-sensitizing, anti-inflammatory, and neuroplasticity effects. Reductions in plasma levels of adiponectin have been reported in both humans with depression and in the chronic-defeat mouse model of depression. However, the predictive value of adiponectin for treatment response to depression has not been determined. Methods We investigated the potential predictive effect of baseline adiponectin levels in patients who provided plasma and were undergoing one of three pharmacological treatments (escitalopram monotherapy; escitalopram plus bupropion; and venlafaxine plus mirtazapine) in the Combining Medications to Enhance Depression Outcomes clinical trial (n = 160). Specifically, we assessed whether adiponectin moderates—that is, differentially predicts—treatment response among the treatment arms. Improvements with treatment were assessed using change in the clinician-rated 30-item Inventory of Depressive Symptomatology (IDS-C) from baseline through week 12. Moderator effects were tested using separate pairwise repeated measures mixed-effects models with a treatment-arm-by-adiponectin interaction. Results Baseline adiponectin levels moderated treatment outcome between two combination therapies. Specifically, low adiponectin predicted better response to escitalopram plus bupropion compared to venlafaxine plus mirtazapine, whereas high adiponectin predicted better response to venlafaxine plus mirtazapine compared to escitalopram plus bupropion (F = 4.84, p = 0.03). Adiponectin levels did not correlate with baseline depression severity (r = −0.03, p = 0.59). Conclusions Antidepressant selection for patients with MDD can be personalized using pre-treatment blood-based biomarkers, such as adiponectin, thereby improving treatment outcomes. |
| Databáze: | OpenAIRE |
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