The loudness dependency of the auditory evoked N1/P2-component as a predictor of the acute SSRI response in depression

Rationale: A serotonergic dysfunction is supposed to play a pathogenetic role in depression, but there is a considerable number of non-responders in the acute treatment of depression with serotonergic agents like SSRI. Thus, an indicator of central serotonergic activity could lead to a more specific pharmacological treatment of depression. In animal and human data there is a growing amount of evidence that a strong loudness dependency of late auditory evoked potentials (LDAEP) is an indicator of low serotonergic activity and vice versa. Objective: In 29 depressive inpatients (DSM-III-R diagnosis 296.x in 28 patients, 300.4 in one patient), the hypothesis was tested that a strong LDAEP prior to treatment can predict a better clinical outcome under SSRI treatment over 4 weeks. Results: Patients with a strong pre-treatment LDAEP had a significantly greater decrease of depressive symptoms (Hamilton Scale for Depression) after 4 weeks than patients with a flat LDAEP. Significantly more responders fell into the group with a high LDAEP. Contrary to what might be expected, a second recording in a subsample of 19 patients after 4 weeks of treatment failed to show changes in the LDAEP. Conclusion: Our finding confirms the hypothesis that a strong LDAEP, indicating a low serotonergic activity, is related to a favorable response to acute SSRI treatment in depression. The LDAEP is a promising tool for the prediction of response to serotonin agonists in depression and it seems to be of clinical importance.

Authors and Affiliations

1. Department of Psychiatry, Laboratory of Clinical Psychophysiology, Free University Berlin, Eschenallee 3, 14050 Berlin, Germany e-mail: gallinat@zedat.fu-berlin.de, Fax: +49-30-306-85-122, , , , , , DE

   J. Gallinat

2. Department of Psychiatry, Laboratory of Clinical Neurophysiology, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336 Munich, Germany, , , , , , DE

   R. Bottlender, G. Juckel, A. Munke-Puchner, G. Stotz, H. -J. Kuss, P. Mavrogiorgou & U. Hegerl

Received: 11 June 1999 / Final version: 27 October 1999

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