Multiple secondary data analyses of TORDIA have identified important predictors of treatment response and relapse .
To up date a comparative effectiveness review ( 1980–2011 ) of treatments for adolescents whose depressive episode or disorder ( MDE/MDD ) did not respond to one or more trials of SSRI antidepressants .
Treatment of Resistant Depression in Adolescents (TORDIA): week 24 outcomes.
OBJECTIVE The purpose of this study was to report on the outcome of participants in the Treatment of Resistant Depression in Adolescents ( TORDIA ) trial after 24 weeks of treatment , including remission and relapse rates and predictors of treatment outcome . METHOD Adolescents ( ages 12 - 18 years ) with selective serotonin reuptake inhibitor (SSRI)-resistant depression were r and omly assigned to either a medication switch alone ( alternate SSRI or venlafaxine ) or a medication switch plus cognitive-behavioral therapy ( CBT ) . At week 12 , responders could continue in their assigned treatment arm and nonresponders received open treatment ( medication and /or CBT ) for 12 more weeks ( 24 weeks total ) . The primary outcomes were remission and relapse , defined by the Adolescent Longitudinal Interval Follow-Up Evaluation as rated by an independent evaluator . RESULTS Of 334 adolescents enrolled in the study , 38.9 % achieved remission by 24 weeks , and initial treatment assignment did not affect rates of remission . Likelihood of remission was much higher ( 61.6 % versus 18.3 % ) and time to remission was much faster among those who had already demonstrated clinical response by week 12 . Remission was also higher among those with lower baseline depression , hopelessness , and self-reported anxiety . At week 12 , lower depression , hopelessness , anxiety , suicidal ideation , family conflict , and absence of comorbid dysthymia , anxiety , and drug/alcohol use and impairment also predicted remission . Of those who responded by week 12 , 19.6 % had a relapse of depression by week 24 . CONCLUSIONS Continued treatment for depression among treatment-resistant adolescents results in remission in approximately one-third of patients , similar to adults . Eventual remission is evident within the first 6 weeks in many , suggesting that earlier intervention among nonresponders could be important
Multiple secondary data analyses of TORDIA have identified important predictors of treatment response and relapse .
To up date a comparative effectiveness review ( 1980–2011 ) of treatments for adolescents whose depressive episode or disorder ( MDE/MDD ) did not respond to one or more trials of SSRI antidepressants .