{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:41:18Z","timestamp":1792078878405,"version":"4.4.0"},"reference-count":35,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR000448"],"award-info":[{"award-number":["UL1 TR000448"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010524","name":"Campbell Family Mental Health Researc\u200bh Institute","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100010524","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013395","name":"Taylor Family Institute for Innovative Psychiatric Research","doi-asserted-by":"crossref","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100013395","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007408","name":"University of Pittsburgh Medical Center","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100007408","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P30 MH90333"],"award-info":[{"award-number":["P30 MH90333"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01 MH083643"],"award-info":[{"award-number":["R01 MH083643"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01 MH083648"],"award-info":[{"award-number":["R01 MH083648"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01 MH083660"],"award-info":[{"award-number":["R01 MH083660"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Evid Based Mental Health"],"accepted":{"date-parts":[[2022,8,31]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Predictors of antidepressant response in older patients with major depressive disorder (MDD) need to be confirmed before they can guide treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To create decision trees for early identification of older patients with MDD who are unlikely to respond to 12 weeks of antidepressant treatment, we analysed data from 454 older participants treated with venlafaxine XR (150\u2013300\u2009mg\/day) for up to 12 weeks in the Incomplete Response in Late-Life Depression: Getting to Remission study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We selected the earliest decision point when we could detect participants who had not yet responded (defined as &gt;50% symptom improvement) but would do so after 12 weeks of treatment. Using receiver operating characteristic models, we created two decision trees to minimise either false identification of future responders (false positives) or false identification of future non-responders (false negatives). These decision trees integrated baseline characteristics and treatment response at the early decision point as predictors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Finding<\/jats:title>\n                  <jats:p>We selected week 4 as the optimal early decision point. Both decision trees shared minimal symptom reduction at week 4, longer episode duration and not having responded to an antidepressant previously as predictors of non-response. Test negative predictive values of the leftmost terminal node of the two trees were 77.4% and 76.6%, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our decision trees have the potential to guide treatment in older patients with MDD but they require to be validated in other larger samples.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical implications<\/jats:title>\n                  <jats:p>Once confirmed, our findings may be used to guide changes in antidepressant treatment in older patients with poor early response.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ebmental-2022-300479","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T13:20:54Z","timestamp":1663075254000},"page":"156-162","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Venlafaxine XR treatment for older patients with major depressive disorder: decision trees for when to change treatment"],"prefix":"10.1136","volume":"25","clinical-trial-number":[{"clinical-trial-number":"nct00892047","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6578-2109","authenticated-orcid":false,"given":"Helena Kyunghee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M","family":"Blumberger","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"},{"name":"Centre for Addiction and Mental Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan F","family":"Karp","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Arizona, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Lenze","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Washington, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles F","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit H","family":"Mulsant","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"},{"name":"Centre for Addiction and Mental Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"key":"2025082702491654000_25.4.156.1","doi-asserted-by":"crossref","DOI":"10.4088\/JCP.21r14034","article-title":"The efficacy of Measurement-Based care for depressive disorders: systematic review and meta-analysis of randomized controlled trials","volume":"82","author":"Zhu","year":"2021","journal-title":"J Clin Psychiatry"},{"key":"2025082702491654000_25.4.156.2","doi-asserted-by":"crossref","DOI":"10.4088\/JCP.18m12483","article-title":"Predicting remission in late-life major depression: a clinical algorithm based upon past treatment history","volume":"80","author":"Buchalter","year":"2019","journal-title":"J Clin Psychiatry"},{"key":"2025082702491654000_25.4.156.3","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201900295"},{"key":"2025082702491654000_25.4.156.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000204471.07214.94"},{"key":"2025082702491654000_25.4.156.5","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.164.6.892"},{"key":"2025082702491654000_25.4.156.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.10.008"},{"key":"2025082702491654000_25.4.156.7","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.106.027169"},{"key":"2025082702491654000_25.4.156.8","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12959"},{"key":"2025082702491654000_25.4.156.9","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1334"},{"key":"2025082702491654000_25.4.156.10","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2008.07081340"},{"key":"2025082702491654000_25.4.156.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2012.07.002"},{"key":"2025082702491654000_25.4.156.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00308-6"},{"key":"2025082702491654000_25.4.156.13","unstructured":"American Psychiatric Association . 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