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Saliva levels of 3‐methoxy‐4‐hydroxyphenylglycol and clinical efficacy of mirtazapine or selective serotonin reuptake inhibitors in patients with major depression
Author(s) -
Egami Maki,
Imamura Yoshiomi,
Nabeta Hiromi,
Mizoguchi Yoshito,
Yamada Shigeto
Publication year - 2013
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.2273
Subject(s) - mirtazapine , depression (economics) , serotonin , saliva , serotonin uptake inhibitors , psychology , psychiatry , medicine , clinical psychology , pharmacology , antidepressant , fluoxetine , receptor , anxiety , economics , macroeconomics
Objective This study compared saliva levels of 3‐methoxy‐4‐hydroxyphenylglycol (sMHPG) in patients with major depressive disorder (MDD) to levels in healthy controls and explored whether sMHPG levels in patients with MDD were a predictive marker for antidepressant efficacy. Methods sMHPG levels were compared in 53 patients with MDD and 275 age‐matched healthy controls. Patients' depressive symptoms were assessed by the 17‐item Hamilton Rating Scale for Depression at baseline and 4 weeks after treatment with selective serotonin reuptake inhibitors (SSRIs, n = 23) or mirtazapine ( n = 30), followed by saliva sampling. The mirtazapine group included nine patients who had been treated with an SSRI for more than 4 weeks without any improvement. sMHPG levels were measured by gas chromatography–mass spectrometry. Results sMHPG levels in MDD patients were significantly higher than in controls. The responder rate to drug treatment at 4 weeks was 62% for mirtazapine (13/21), 57% for SSRIs (13/23), and 89% (8/9) for SSRI plus mirtazapine. sMHPG at baseline in 13 responders treated with SSRIs, but not mirtazapine, was significantly higher than that in non‐responder group and showed consequent reduction 4 weeks after treatment. The area under the receiver operating characteristic (ROC) curves of sMHPG for discrimination of SSRI responders and non‐responders was 0.86 ± 0.10 (95% confidence interval: 0.64–1.0, p = 0.005). In contrast, the ROC curve of sMHPG levels for discrimination of mirtazapine responders and non‐responders was not significant. Adjunctive treatment with mirtazapine to SSRI non‐responders was effective, regardless of baseline sMHPG levels. Conclusion sMHPG in patients with MDD was higher than in healthy controls. High baseline sMHPG levels in patients with MDD maybe a predictive marker for SSRI response. Copyright © 2012 John Wiley & Sons, Ltd.