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Auditory Evoked Potentials and 123I-β-CIT-SPECT as predictors of the differential response to serotonergic versus noradrenergic antidepressants
Background: Neurophysiological („loudness dependence of auditory evoked potentials“/LDAEP) and imaging ([123I]β-CIT-SPECT) techniques are tools to investigate the serotonergic system (1–3). Aim of this study is to provide evidence, that these methods are indicators of serotonergic function in depressed patients and can be used as differential predictors of the response to antidepressants.
Methods: Patients with depression were enrolled into a 4-week treatment study with either citalopram (CP) or reboxetine (RX). Neurophysiological and imaging studies were performed at baseline, the patients were clinically assessed by HAM-D-scores (therapeutic responses: >50%-reduction in HAM-D-scores).
Results: Patients were stratified according to treatment response. Analyses revealed sensitivity, specificity, positive predictive values for LDAEP to identify CP-responders of 83%, 67%, and 83%, respectively.
Conclusion: Preliminary data provide evidence that a successful individual prediction of treatment responses is feasible. Further validation is under way by an increase in patient recruitment and the use of imaging techniques as additional serotonergic measures.
1. Hegerl, U. et al. J Affect Disord. 62 (2001):93–100.
2. Kuikka, JT. et al. Eur J Nucl Med. 22 (1995):346–50.
3. Gallinat et al. Psychopharmacology 148 (2000):404–11.