The loudness dependency of the auditory evoked N1/P2-component as a predictor of the acute SSRI response in depression

• Published in: Psychopharmacologia 2000-03, Vol.148 (4), p.404-411
• Main Authors: GALLINAT, J, BOTTLENDER, R, JUCKEL, G, MUNKE-PUCHNER, A, STOTZ, G, KUSS, H.-J, MAVROGIORGOU, P, HEGERL, U
• Format: Article
• Language: English
• Subjects: Acoustic Stimulation; Auditory evoked potentials; Biological and medical sciences; Depressive Disorder - drug therapy; Depressive Disorder - psychology; Drug therapy; Evoked Potentials, Auditory - drug effects; Female; Humans; Hypotheses; Male; Medical sciences; Mental depression; Middle Aged; Neuropharmacology; Neurotransmitters. Neurotransmission. Receptors; Patients; Pharmacology. Drug treatments; Predictive Value of Tests; Psychiatric Status Rating Scales; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Serotonin uptake inhibitors; Serotonin Uptake Inhibitors - therapeutic use; Serotoninergic system; Time Factors
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s002130050070

A serotonergic dysfunction is supposed to play a pathogenetic role in depression, but there is a considerable number of non-responders in the acute treatment of depression with serotonergic agents like SSRI. Thus, an indicator of central serotonergic activity could lead to a more specific pharmacological treatment of depression. In animal and human data there is a growing amount of evidence that a strong loudness dependency of late auditory evoked potentials (LDAEP) is an indicator of low serotonergic activity and vice versa. In 29 depressive inpatients (DSM-III-R diagnosis 296.x in 28 patients, 300.4 in one patient), the hypothesis was tested that a strong LDAEP prior to treatment can predict a better clinical outcome under SSRI treatment over 4 weeks. Patients with a strong pre-treatment LDAEP had a significantly greater decrease of depressive symptoms (Hamilton Scale for Depression) after 4 weeks than patients with a flat LDAEP. Significantly more responders fell into the group with a high LDAEP. Contrary to what might be expected, a second recording in a subsample of 19 patients after 4 weeks of treatment failed to show changes in the LDAEP. Our finding confirms the hypothesis that a strong LDAEP, indicating a low serotonergic activity, is related to a favorable response to acute SSRI treatment in depression. The LDAEP is a promising tool for the prediction of response to serotonin agonists in depression and it seems to be of clinical importance.