Comparison of the effectiveness of duloxetine in depressed patients with and without a family history of affective disorders in first-degree relatives

BACKGROUND: It remains unclear whether or not a positive family history of affective disorders predicts the effectiveness of antidepressant treatment of depression. AIMS: Assess the relationship of a family history of affective disorders to the efficacy of duloxetine in the treatment of depressive disorder. METHODS: Seventy-seven patients with depressive disorder (as defined by the 10th edition of the International Classification of Diseases, ICD-10) were enrolled in the study and treated with standard doses of duloxetine for 12 weeks. Among these patients 37 had a family history of affective disorder in first-degree relatives and 40 did not. The Hamilton Depression rating scale (HAMD-17), Hamilton Anxiety rating scale (HAMA), Side Effects Rating Scale (SERS), Snaith-Hamilton Pleasure Scale (SHAPS), and Beck Depression Inventory (BDI) were assessed at baseline and at the end of the 2(nd), 4(th), 6(th), 8(th), and 12(th) week after enrollment. Repeated measures analysis of variance and logistic regression were used to analyze the association between a family history of affective disorders and the efficacy of duloxetine. RESULTS: Patients with a positive family history of affective disorders had an earlier age of onset, a longer duration of illness, a higher level of psychic anxiety, and more prominent anhedonia. Repeated measures analysis of variance showed a significant improvement in the severity of depression over the 12 weeks but no differences in the magnitude or speed of improvement between the two groups. Treatment was considered effective (i.e., drop in baseline HAMD-17 total score of ≥50%) in 75.7% of those with a family history of affective disorders and in 77.5% of those without a family history (X(2)=0.04, p=0.850). CONCLUSIONS: Family history of affective disorders is not associated with the effectiveness of duloxetine in the acute treatment of depressive disorder.