Predictors of fluoxetine remission for hospitalized patients with major depressive disorder


Cheng-Fang Yen, MD, PhD, Department of Psychiatry, Kaohsiung Medical University Hospital, 100 Tzyou 1st Rd, Kaohsiung 807, Taiwan. Email:


Aim:  The goal of treating major depressive disorder is to achieve remission. This prospective study aimed to identify predictors of remission in a cohort of depressive inpatients who received fluoxetine.

Methods:  A total of 131 newly hospitalized patients with major depressive disorder received a fixed dose of 20 mg/day (the recommended dose from the literature) of fluoxetine for 6 weeks. Symptom severity was assessed using the 17-item Hamilton Depression Rating Scale at weeks 0, 1, 2, 3, 4 and 6. Remission was defined as a score of ≤7 on the 17-item Hamilton Depression Rating Scale after 6 weeks of treatment. We compared the remitters and non-remitters in terms of baseline variables. The Short-Form-36 pain interference item was used to assess pain. It was classified as high (score ≥ 3) or low (score < 3).

Results:  A total of 31 (27.7%) of 112 completers remitted after 6 weeks of treatment. The remitters and non-remitters did not differ in baseline variables, except pain interference, baseline depression severity, and depression improvement at week 1.

Conclusion:  These findings obtained from newly hospitalized major depression patients support the previous notion that pain interference, depression severity, and early improvement can be the predictors for remission. Patients with high pain interference, a greater depression severity or a less early improvement are likely to require aggressive treatment early. These data require confirmation and extension to outpatients and other antidepressants.