Pretreatment frontal EEG and changes in suicidal ideation during SSRI treatment in major depressive disorder

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Abstract
Objective:  We investigated frontal quantitative EEG (QEEG) as predictor of changes in suicidal ideation (SI) during SSRI treatment in major depressive disorder (MDD).Method:  Eighty‐two subjects meeting DSM‐IV criteria for MDD entered an 8‐week, prospective, open‐label treatment with flexible dose SSRIs and completed at least 4 weeks of treatment. We assessed MDD severity with the 17‐item Hamilton Depression Rating Scale (HAM‐D‐17); change in SI was measured with HAM‐D item no. 3. We recorded four‐channel EEGs (F7‐Fpz, F8‐Fpz, A1‐Fpz, A2‐Fpz) before treatment.Results:  During the first 4 weeks of treatment 9 (11%) subjects experienced worsening SI. Left‐right asymmetry of combined theta + alpha power correlated significantly with change in SI from baseline, even when adjusting for changes in depression severity (HAM‐D‐17) and for the SSRI utilized.Conclusion:  Frontal QEEG parameters before treatment may predict worsening SI during SSRI treatment in MDD.

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