TY - JOUR
T1 - The use of referenced-EEG (rEEG) in assisting medication selection for the treatment of depression
AU - DeBattista, Charles
AU - Kinrys, Gustavo
AU - Hoffman, Daniel
AU - Goldstein, Corey
AU - Zajecka, John
AU - Kocsis, James
AU - Teicher, Martin
AU - Potkin, Steven
AU - Preda, Adrian
AU - Multani, Gurmeet
AU - Brandt, Len
AU - Schiller, Mark
AU - Iosifescu, Dan
AU - Fava, Maurizio
N1 - Funding Information:
Dr. Martin H. Teicher has received (throughout his lifetime) research support from: NIMH, NIDA, NARSAD, Tourette’s Syndrome Association, Scottish Rite Schizophrenia Research Program, ADAMHA, USPHS, LiteBook, CNS Response, BioBehavioral Diagnostic Co., Kodak, GlaxoSmithKline, Wyeth-Ayerst, OPTAx Systems Inc., Sepracor, SunBox, Ambulatory Monitoring Inc., Copley Pharmaceuticals, Glaxo-Welcome, Sandoz and Mead Johnson. Dr Martin H. Teicher has spoken with support from the following companies: BioBehavioral Diagnostic Co., Bristol-Myers Squib, Glaxo-Welcome, Optax Systems Inc., Upjohn, Cell-tech, Cephalon, J & J Pharmaceuticals and Eli Lilly. Dr. Martin H. Teicher has served on the Scientific Advisory Board of the following companies: OPTAx Systems Inc. and BioBehavioral Diagnostic Co. and has received consulting fees from these companies. He has also received consulting fees from MDCI, Copley Pharmaceuticals, Watson Pharmaceuticals, Sention, Sepracor and Ambulatory Monitoring Inc. Dr. Martin H. Teicher holds 13 US Patents and has received patent royalties for inventions licensed through McLean Hospital to Sepracor, Optax Systems Inc, and BioBehavioral Diagnostic Co.
Funding Information:
Dr. James H. Kocsis has received research support from: NIMH, NIDA, Burroughs Wellcome Trust, Pritzker Consortium, Astra-Zeneca, Sanofi Aventis, Forest, Novartis, CNS Response, Roche. Dr. James H. Kocsis has spoken with support from: Pfizer, Wyeth, Astra-Zeneca. Dr. James H. Kocsis has served on an advisory board for: Pfizer and Wyeth.
PY - 2011/1
Y1 - 2011/1
N2 - Objective: To evaluate the efficacy of rEEG®-guided pharmacotherapy for the treatment of depression in those circumstances where rEEG and STAR*D provided different recommendations. Materials and methods: This was a randomized, single-blind, parallel group, 12 center, US study of rEEG-guided pharmacotherapy vs. the most effective treatment regimens reported in the NIH sponsored STAR*D study. Relatively treatment-resistant subjects ≥18 years who failed one or more antidepressants were required to have a QIDS-16-SR score ≥13 and a MADRS score ≥26 at baseline. All subjects underwent a washout of all current medications (with some protocol-specified exceptions) for at least five half-lives before receiving a QEEG and rEEG report. Subjects randomized to rEEG were assigned a regimen based on the rEEG report. Control subjects who had failed only SSRI's in their current episode were randomized to receive venlafaxine XR. Control subjects who had failed antidepressants from ≥2 classes of antidepressants were randomized to receive a regimen from Steps 2-4 of the STAR*D study. Treatment lasted 12 weeks. The primary outcome measures were change from baseline for self-rated QIDS-SR16 and Q-LES-Q-SF. Results: A total of 114 subjects were randomized and 89 subjects were evaluable. rEEG-guided pharmacotherapy exhibited significantly greater improvement for both primary endpoints, QIDS-SR16 (-6.8 vs. -4.5, p<0.0002) and Q-LES-Q-SF (18.0 vs. 8.9, p<0.0002) compared to control, respectively, as well as statistical superiority in 9 out of 12 secondary endpoints. Conclusions: These results warrant additional studies to determine the role of rEEG-guided psychopharmacology in the treatment of depression. If these results were confirmed, rEEG-guided pharmacotherapy would represent an easy, relatively inexpensive, predictive, objective office procedure that builds upon clinical judgment to guide antidepressant medication choice.
AB - Objective: To evaluate the efficacy of rEEG®-guided pharmacotherapy for the treatment of depression in those circumstances where rEEG and STAR*D provided different recommendations. Materials and methods: This was a randomized, single-blind, parallel group, 12 center, US study of rEEG-guided pharmacotherapy vs. the most effective treatment regimens reported in the NIH sponsored STAR*D study. Relatively treatment-resistant subjects ≥18 years who failed one or more antidepressants were required to have a QIDS-16-SR score ≥13 and a MADRS score ≥26 at baseline. All subjects underwent a washout of all current medications (with some protocol-specified exceptions) for at least five half-lives before receiving a QEEG and rEEG report. Subjects randomized to rEEG were assigned a regimen based on the rEEG report. Control subjects who had failed only SSRI's in their current episode were randomized to receive venlafaxine XR. Control subjects who had failed antidepressants from ≥2 classes of antidepressants were randomized to receive a regimen from Steps 2-4 of the STAR*D study. Treatment lasted 12 weeks. The primary outcome measures were change from baseline for self-rated QIDS-SR16 and Q-LES-Q-SF. Results: A total of 114 subjects were randomized and 89 subjects were evaluable. rEEG-guided pharmacotherapy exhibited significantly greater improvement for both primary endpoints, QIDS-SR16 (-6.8 vs. -4.5, p<0.0002) and Q-LES-Q-SF (18.0 vs. 8.9, p<0.0002) compared to control, respectively, as well as statistical superiority in 9 out of 12 secondary endpoints. Conclusions: These results warrant additional studies to determine the role of rEEG-guided psychopharmacology in the treatment of depression. If these results were confirmed, rEEG-guided pharmacotherapy would represent an easy, relatively inexpensive, predictive, objective office procedure that builds upon clinical judgment to guide antidepressant medication choice.
KW - Antidepressants
KW - Biomarkers
KW - QEEG
KW - REEG
KW - Resistant depression
KW - Response prediction
UR - http://www.scopus.com/inward/record.url?scp=78650948927&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychires.2010.05.009
DO - 10.1016/j.jpsychires.2010.05.009
M3 - Article
C2 - 20598710
AN - SCOPUS:78650948927
SN - 0022-3956
VL - 45
SP - 64
EP - 75
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
IS - 1
ER -