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Psychomotor depressive symptoms may differentially respond to venlafaxine

Singh, Ajeet B.a,b; Bousman, Chad A.b,c,f,d; Ng, Chee H.b; Byron, Keithg; Berk, Michaela,b,d,e

International Clinical Psychopharmacology: May 2013 - Volume 28 - Issue 3 - p 121–126
doi: 10.1097/YIC.0b013e32835f1b9f
Original Articles

Predicting differential antidepressant efficacy remains an elusive goal in major depressive disorder (MDD). The aims of this study were three-fold. Firstly, to examine if psychomotor retardation symptoms (item 8 on the 17-item Hamilton Depression Rating Scale) improve preferentially to venlafaxine (VEN) over escitalopram (ESC) treatment. Secondly, whether the 18 item CORE psychomotor signs scale predicted antidepressant remission. Finally, to investigate the role of two norepinephrine transporter gene (NET) polymorphisms (rs2242446 and rs5569) on antidepressant efficacy. Adults with Diagnostic and Statistical Manual of Mental Disorders, 4th ed. MDD (n=113) were treated with ESC or VEN prospectively for 8 weeks and rated serially with the Hamilton Depression Rating Scale. In a subsample (n=51) of patients from one of the three recruitment sites, the CORE psychomotor signs scale was also administered at baseline. Participants treated with VEN had significantly greater reduction in psychomotor retardation symptoms than those treated with ESC. The CORE scale did not predict antidepressant response or remission. Neither NET polymorphism moderated antidepressant efficacy. Findings suggest possible preferential utility of a selective serotonin and noradrenaline reuptake inhibitor in cases of MDD presenting with greater psychomotor retardation. The moderate to small sample size makes a type II error risk possible, and the negative findings need to be interpreted with caution. The positive finding of preferential efficacy of VEN for psychomotor retardation symptoms has potential translational utility.

aSchool of Medicine, Deakin University, Geelong

Departments of bPsychiatry

cGeneral Practice, The University of Melbourne

dFlorey Institute for Neuroscience and Mental Health

eOrygen Youth Health Research Centre, Centre for Youth Mental Health, Parkville

fCentre for Human Psychopharmacology, Swinburne University of Technology, Hawthorne

gHealthscope Pathology, Clayton, Victoria, Australia

Correspondence to Dr Ajeet B. Singh, MBBS, MPsych, FRANZCP, School of Medicine, Deakin University, Geelong, PO Box 9148, St Albans Park, Victoria 3219, Australia Tel: +61 352 487 211; fax: +61 352 484 767; e-mail:

Received November 7, 2012

Accepted January 17, 2013

© 2013 Lippincott Williams & Wilkins, Inc.