Early reduction in painful physical symptoms is associated with improvements in long-term depression outcomes in patients treated with duloxetine

• Published in: BMC psychiatry Vol. 11; no. 1; p. 150
• Main Authors: Schneider, Edith, Linden, Michael, Weigmann, Harald, Wagner, Thomas, Quail, Deborah, Hundemer, Hans-Peter, Hegerl, Ulrich
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.09.2011; BioMed Central; BMC
• Subjects: Antidepressants; Antidepressive Agents - adverse effects; Antidepressive Agents - therapeutic use; Care and treatment; Clinical medicine; Depression; Depression - complications; Depression - drug therapy; Depression, Mental; Diabetic neuropathy; Drug therapy; duloxetine; Duloxetine Hydrochloride; Female; Humans; International Classification of Diseases - statistics & numerical data; Likert scale; Male; Mental depression; Middle Aged; non-interventional study; Outpatients - psychology; Pain; Pain - complications; Pain - drug therapy; Pain Measurement - drug effects; Pain Measurement - methods; painful physical symptoms; Prospective Studies; Psychiatry; Serotonin; Severity of Illness Index; Studies; Thiophenes - adverse effects; Thiophenes - therapeutic use; Writing; United Kingdom; Germany
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/1471-244X-11-150

To investigate the association of the change of painful physical symptoms (PPS) after 4 weeks, with the 6-month treatment outcomes of depressive symptoms in patients treated with duloxetine in clinical practice. Multicenter, prospective, 6-month, non-interventional study in adult outpatients with a depressive episode and starting treatment with duloxetine. Depression severity was assessed by the clinician (Inventory for Depressive Symptomatology [IDS-C]) and patient (Kurz-Skala Stimmung/Aktivierung [KUSTA]). Somatic symptoms and PPS were assessed using the patient-rated Somatic Symptom Inventory (SSI) and visual analog scales (VAS) for pain items. Association of change in PPS with outcomes of depressive symptoms was analyzed based on mean KUSTA scores (mean of items mood, activity, tension/relaxation, sleep) and achievement of a 50% reduction in the total IDS-C score after 6 months using linear and logistic regression models, respectively. Of the 4,517 patients enrolled (mean age: 52.2 years, 71.8% female), 3,320 patients (73.5%) completed the study. 80% of the patients had moderate to severe overall pain (VAS > 30 mm) at baseline. A 50% VAS overall pain reduction after 4 weeks was associated with a 13.32 points higher mean KUSTA score after 6 months, and a 50% pain reduction after 2 weeks with a 6.33 points improvement. No unexpected safety signals were detected in this naturalistic study. Pain reduction after 2 and 4 weeks can be used to estimate outcomes of long-term treatment with duloxetine. PPS associated with depression have a potential role in predicting remission of depressive symptoms in clinical practice.