An exploratory study of adolescent response to fluoxetine using psychological and biological predictors

• Main Authors: Ada H. Zohar, Tamar Eilat, Maya Amitai, Michal Taler, Romi Bari, Alon Chen, Alan Apter, Avraham Weizman, Silvana Fennig
• Format: Article
• Language: English
• Published: PeerJ Inc. 2018-01-01
• Series: PeerJ
• Subjects: Fluoxetine; Adolescent; Treatment response; Ex post-facto study; Type D personality; Personality
• Online Access: https://peerj.com/articles/4240.pdf

Background Not enough is known about predicting therapeutic response to serotonin-specific reuptake inhibitors, and specifically to fluoxetine. This exploratory study used psychological and biological markers for (retrospective) prediction of treatment-response to fluoxetine in depressed and/or anxious adolescents. Methods Forty-one consecutive adolescent outpatients with a primary diagnosis of severe affective and/or anxiety disorders were assessed and treated with an open-label 8-week trial of fluoxetine. Type D personality was assessed with the 14-item questionnaire, the DS14. In addition, TNFα, IL-6, and IL-1b were measured pre- and post-treatment. Results There was an elevation of Type D personality in patients, compared to the adolescent population rate. Post-treatment, 44% of patients were classified as non-responders; the relative risk of non-response for Type D personality patients was 2.8. Binary logistic regression predicting response vs. non-response showed a contribution of initial TNFα levels as well as Type D personality to non-response. Conclusions In this exploratory study, the most significant contributor to non-response was Type D personality. However, the measurement of Type D was not prospective, and thus may be confounded with psychiatric morbidity. The measurement of personality in psychiatric settings may contribute to the understanding of treatment response and have clinical utility.