Psychomotor depressive symptoms may differentially respond to venlafaxine.
Level 3 - non-randomized controlled study
Prospective comparative multicenter study; randomization is not specified in the abstract.
PubMed 23442739 · doi:10.1097/YIC.0b013e32835f1b9f
What was done
Adults with DSM-IV major depressive disorder (n = 113) were treated prospectively for 8 weeks with either venlafaxine or escitalopram across three recruitment sites. Depression severity was tracked serially using the 17-item Hamilton Depression Rating Scale (HDRS), with item 8 assessing psychomotor retardation. In a subsample of 51 patients from one site, the 18-item CORE psychomotor signs scale was administered at baseline. The study also tested whether two norepinephrine transporter gene polymorphisms (rs2242446 and rs5569) moderated treatment response.
What was found
Participants treated with venlafaxine had a significantly greater reduction in psychomotor retardation symptoms than those treated with escitalopram. The CORE psychomotor scale did not predict response or remission. Neither norepinephrine transporter gene polymorphism moderated antidepressant efficacy. No specific numerical values, effect sizes, or p-values were reported in the abstract.
Why it matters
This study suggests that major depressive disorder presenting with prominent psychomotor retardation may preferentially respond to a dual serotonin-norepinephrine reuptake inhibitor over a selective serotonin reuptake inhibitor.
Limits
The abstract reports no exact numeric results, test statistics, or p-values, and does not state whether treatment allocation was randomized or blinded. The sample size is modest (n = 113 overall, n = 51 for the CORE scale), creating risk of type II errors for the null findings.
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