Prozac Research Today is a free monthly online journal that collates and summarizes the latest research about Prozac, including details on depression, side-effects, withdrawal, alternatives.

Achievement and maintenance of sustained response during the Treatment for Adolescents With Depression Study continuation and maintenance therapy.

Rohde P, Silva SG, Tonev ST, Kennard BD, Vitiello B, Kratochvil CJ, Reinecke MA, Curry JF, Simons AD, March JS

Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403-1983, USA. paulr@ori.org

CONTEXT: The Treatment for Adolescents With Depression Study evaluated fluoxetine (FLX), cognitive behavioral therapy (CBT), and FLX/CBT combination (COMB) vs pill placebo in 439 adolescents with major depressive disorder. Treatment consisted of 3 stages: (1) acute (12 weeks), (2) continuation (6 weeks), and (3) maintenance (18 weeks). OBJECTIVE: To examine rates of achieving and maintaining sustained response during continuation and maintenance treatments. DESIGN: Randomized controlled trial. Response was determined by blinded independent evaluators. SETTING: Thirteen US sites. PATIENTS: Two hundred forty-two FLX, CBT, and COMB patients in their assigned treatment at the end of stage 1. INTERVENTIONS: Stage 2 treatment varied based on stage 1 response. Stage 3 consisted of 3 CBT and/or pharmacotherapy sessions and, if applicable, continued medication. MAIN OUTCOME MEASURES: Sustained response was defined as 2 consecutive Clinical Global Impression-Improvement ratings of 1 or 2 ("full response"). Patients achieving sustained response were classified on subsequent nonresponse status. RESULTS: Among 95 patients (39.3%) who had not achieved sustained response by week 12 (29.1% COMB, 32.5% FLX, and 57.9% CBT), sustained response rates during stages 2 and 3 were 80.0% COMB, 61.5% FLX, and 77.3% CBT (difference not significant). Among the remaining 147 patients (60.7%) who achieved sustained response by week 12, CBT patients were more likely than FLX patients to maintain sustained response through week 36 (96.9% vs 74.1%; P = .007; 88.5% of COMB patients maintained sustained response through week 36). Total rates of sustained response by week 36 were 88.4% COMB, 82.5% FLX, and 75.0% CBT. CONCLUSIONS: Most adolescents with depression who had not achieved sustained response during acute treatment did achieve that level of improvement during continuation and maintenance therapies. The possibility that CBT may help the subset of adolescents with depression who achieve early sustained response maintain their response warrants further investigation. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00006286.

Published 8 April 2008 in Arch Gen Psychiatry, 65(4): 447-55.
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Articles on Prozac published 12 February 2008:

Simultaneous determination of citalopram, fluoxetine and their main metabolites in human urine samples by solid-phase microextraction coupled with high-performance liquid chromatography.   J Pharm Biomed Anal, 46(4): 763-70.

A liquid chromatography method was developed for the determination of some frequently prescribed selective serotonin re-uptake inhibitors (SSRI) - citalopram and fluoxetine - and its main metabolites - demethylcitalopram, didemethylcitalopram and norfluoxetine - in human urine samples, using a previous stage of solid-phase microextraction. All the extraction parameters influencing adsorption (extraction time, temperature, pH, ion strength and organic modifier addition) and desorption ... [Abstract] [Full-text]

Quality assessment of fluoxetine and fluvoxamine pharmaceutical formulations purchased in different countries or via the Internet by 19F and 2D DOSY 1H NMR.   J Pharm Biomed Anal, 46(4): 707-22.

A simple and selective (19)F NMR method has been validated for the quantitation of fluoxetine (FLX) and fluvoxamine (FLV) in methanol solutions and in human plasma and urine. The regression equations for FLX and FLV showed a good linearity in the range of 1.4-620 microg mL(-1) (3.3 x 10(-6)-1.8 x 10(-3) mol L(-1)) with a limit of detection of approximately 0.5 microg mL(-1) (1.3 x 10(-6) mol L(-1)) and a limit of quantification of approximately 2 microg mL(-1) (4.6 x 10(-6) mol L(-1)). The ... [Abstract] [Full-text]

Articles on Prozac published 7 February 2008:

Chronic fluoxetine stimulates maturation and synaptic plasticity of adult-born hippocampal granule cells.   J Neurosci, 28(6): 1374-84.

Chronic treatments with selective serotonin reuptake inhibitors (SSRIs) have been shown to increase hippocampal neurogenesis. However, it is not known whether SSRIs impact the maturation and functional integration of newborn neurons. Here we examined the effects of subchronic and chronic fluoxetine on the structural and physiological properties of young granule cells. Our results show that doublecortin-positive immature neurons displayed increased dendritic arborization after chronic fluoxetine ... [Abstract] [Full-text]

Articles on Prozac published 1 February 2008:

Regionally specific regulation of ERK MAP kinase in a model of antidepressant-sensitive chronic depression.   Biol Psychiatry, 63(4): 353-9.

BACKGROUND: Elevated phosphorylation of neurotrophin-regulated transcription factors, such as cyclic adenosine monophosphate (cAMP)-response element binding protein (CREB), in the hippocampus has been proposed as a common mediator of antidepressant (ADT) efficacy in otherwise naive rodents. The intracellular factors by which ADTs and glucocorticoids, causal factors in depression, regulate depression-like behavior remain unclear, but extracellular signal-regulated kinase 1/2 (ERK1/2), upstream ... [Abstract] [Full-text]

Articles on Prozac published 15 January 2008:

Antidepressant treatment can normalize adult behavioral deficits induced by early-life exposure to methylphenidate.   Biol Psychiatry, 63(3): 309-16.

BACKGROUND: Methylphenidate (MPH) is prescribed for the treatment of attention-deficit/hyperactivity disorder. Exposure to MPH before adulthood causes behavioral deficits later in life, including anxiety- and depression-like behaviors and decreased responding to natural and drug rewards. We examined the ability of fluoxetine (FLX), a selective serotonin reuptake blocker, to normalize these MPH-induced behavioral deficits. METHODS: Male rats received MPH (2.0 mg/kg) or saline (VEH) during ... [Abstract] [Full-text]

Articles on Prozac published 10 January 2008:

Increase in neurogenesis and behavioural benefit after chronic fluoxetine treatment in Wistar rats.   Acta Neurol Scand, 117(2): 94-100.

OBJECTIVE: Disturbances in hippocampal neurogenesis may be involved in the pathophysiology of depression and it has been argued that an increase in the generation of new nerve cells in the hippocampus is involved in the mechanism of action of antidepressants. MATERIALS AND METHODS: Adult Wistar rats were treated with fluoxetine (10 mg/kg) 1 h, daily for 5 (subchronic) or 28 days (chronic) before the Novelty Suppressed Feeding test was performed. Cell proliferation and neurogenesis were analysed ... [Abstract] [Full-text]

Articles on Prozac published 6 December 2007:

Fish on Prozac: a simple, noninvasive physiology laboratory investigating the mechanisms of aggressive behavior in Betta splendens.   Adv Physiol Educ, 31(4): 358-63.

The neuromodulator serotonin is an important regulator of aggressive behavior in vertebrates. Experimentally increasing synaptic levels of serotonin with fluoxetine, a selective serotonin reuptake inhibitor, has been shown to reliably decrease the expression of aggressive behavior. Here, we describe a method by which fluoxetine can be noninvasively administered to male Betta splendens (an attractive model for the study of aggressive behavior) and describe a simple laboratory exercise that ... [Abstract] [Full-text]

Articles on Prozac published 6 November 2007:

Prenatal exposure to fluoxetine induces fetal pulmonary hypertension in the rat.   Am J Respir Crit Care Med, 176(10): 1035-40.

RATIONALE: Fluoxetine is a selective serotonin reuptake inhibitor antidepressant widely used by pregnant women. Epidemiological data suggest that fluoxetine exposure prenatally increases the prevalence of persistent pulmonary hypertension syndrome of the newborn. The mechanism responsible for this effect is unclear and paradoxical, considering the current evidence of a pulmonary hypertension protective fluoxetine effect in adult rodents. OBJECTIVES: To evaluate the fluoxetine effect on fetal ... [Abstract] [Full-text]

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