HAM-D₁₇ and HAM-D₆ Sensitivity to Change in Relation to Desvenlafaxine Dose and Baseline Depression Severity in Major Depressive Disorder

Abstract

Introduction: This retrospective analysis compared sensitivity to change on the 17-item and 6-item Hamilton rating scales for depression (HAM-D₁₇ and HAM-D₆, respectively) in relation to antidepressant dose and baseline depression severity.

Methods: Data were derived from 6 randomized, double-blind, placebo-controlled, 8-week trials of fixed-dose desvenlafaxine (50, 100, 200 or 400 mg/d) for major depressive disorder. HAM-D₁₇ and HAM-D₆ effect sizes were assessed.

Results: HAM-D₁₇ effect sizes were negative (favoured placebo) for higher desvenlafaxine doses (200–400 mg/d) at week 1, but were positive for all doses after week 2, with no clear dose-response pattern. However, HAM-D₆ effect sizes were positive for all doses at all weeks. Effect sizes were consistently greater for HAM-D₆ vs. HAM-D₁₇, regardless of time spent under therapy. Effect sizes were greater for HAM-D₆ vs. HAM-D₁₇ for all desvenlafaxine doses among patients with baseline HAM-D₁₇ <25, but not among patients with baseline HAM-D₁₇ ≥25.

Discussion: The HAM-D₆ demonstrated greater sensitivity to change and robustness than the HAM-D₁₇, supporting the greater homogeneity of the HAM-D₆.

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