Factors Affecting Antidepressant Response Trajectories: A Veterans Affairs Augmentation and Switching Treatments for Improving Depression Outcomes Trial Report
Academic Article
Overview
Research
Identity
Other
View All
Overview
abstract
BackgroundIn this secondary analysis of the VA Augmentation and Switching Treatments for Improving Depression Outcomes (VASTD) study we used antidepressant response trajectories to assess the association of treatment and multiple clinical/demographic factors with the probability of response.MethodsUsing data from VASTD, a multisite, randomized, singleblind trial with parallelassignment to one of three treatment interventions in 1522 Veteranswhose major depressive disorder was unresponsive to at least one antidepressant trial, we evaluated response patterns using groupbased trajectory modeling (GBTM). A weighted multinomial logistic regression analysis withbackward elimination and additional exploratory analyses were performed to evaluate the association ofmultiple clinical/demographic factors with the probability of inclusion into specific trajectories. Additional exploratory analyses were used to identify factors associated with trajectory group membership that could have been missed in the primary analysis.ResultsGBTM showed the best fit for depression symptom change was comprised of six trajectories, with some trajectories demonstrating minimal improvement and others showing a high probability of remission. High baseline depression and anxiety severity scores decreased, and early improvement increased, the likelihood of inclusion into the most responsive trajectory in both the GBTM and exploratory analyses.ConclusionWhile multiple factors influence responsiveness, the probability of inclusion into a specific depression symptom trajectory is most strongly influenced by three factors: baseline depression, baseline anxiety, and the presence of early improvement.
