[Predictive factors for therapeutic success in depressive syndrome]

In this retrospektive investigation on 659 depressive outpatients, predictors of antidepressant drug response were evaluated. In accordance with the literature, neither demographic variables nor duration of the current episode, severity of depressive symptoms or scores of rating scales showed any clinically relevant relation to outcome. The prognostic value of recovery within the first 2 weeks seems to be the only reliable predictor. In all, 75% of patients without a significant reduction (less than 20%) of the score in the Hamilton Psychiatric Rating Scale for Depression after 2 weeks of treatment will not fulfill response criteria after 6 weeks. For clinical practice these results imply the necessity of reviewing the applied drug regimen early, i.e. about 2 weeks after beginning, to check for compliance with treatment or an individual problem of resorption or metabolism in order to amend the regimen by increasing dosage and/or adding sleep deprivation, lithium, thyroxine or psychotherapy.