Individual Differences in Response to Antidepressants
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Antidepressants are commonly used to treat the major depressive disorder (MDD). Individual differences may not underlie variability in the association between total depression scores and antidepressant treatment; future efforts toward personalization should focus on individual symptoms or biomarkers.

The objective of this study by JAMA Psychiatry was to investigate the assumption of systematic variability in symptomatic response to antidepressants and to assess whether variability is associated with MDD severity, antidepressant class, or study publication year.

Data used were updated from a network meta-analysis of treatment with licensed antidepressants in adults with MDD. The Cochrane Central Register of Controlled Trials, CINAHL, Embase, LILACS database, MEDLINE, MEDLINE In-Process, and PsycInfo were searched. Additional sources were international trial registries and sponsors, drug companies and regulatory agencies’ websites, and reference lists of published articles.

--In the 91 eligible trials (18965 participants), variability in response did not differ significantly between antidepressants and placebo.

--This finding is consistent with a range of treatment effect SDs, depending on the association between the antidepressant and placebo effects.

--Variability was not associated with baseline MDD severity or publication year.

--Responses to noradrenergic agents were 11% more variable than responses to selective serotonin reuptake inhibitors.

In conclusion, although this study cannot rule out the possibility of treatment effect heterogeneity, it does not provide empirical support for personalizing antidepressant treatment based solely on total depression scores.