Hamilton Depression Rating Scale

Winokur et al. (Winokur et al. 2000) found that mirtazapine significantly decreased sleep latency and increased total sleep time and sleep efficiency from baseline levels during week 1, with similar results observed after week 2. Mirtazapine did not significantly alter REM sleep parameters. Clinically, the Hamilton Depression Rating Scale and sleep disturbance ratings improved after treatment. 

Gibbons, R.D., Clark, D.C., Kupfer, D.J. Exactly what does the Hamilton Depression Rating Scale measure J. Psychiatr. Res. 27, 259-273, 1993. 

Williams, J.B.W. A structured interview guide for the Hamilton Depression Rating Scale. Arch. Gen. Psychiatry 45, 742-747, 1988. 

Throughout the rest of this chapter, response and remission rates are used. Therefore, these concepts are briefly discussed here. Response is most often defined as a 50% or greater reduction in symptom severity as measured by a standardized rating assessment such as the Hamilton Depression Rating Scale (HDRS). The drawback to this approach is that response does not differentiate between partial and complete response, particularly when the initial symptom severity is high. Thus, a patient could be classified as a responder and still be quite symptomatic. In some instances, a patient could be classified as responder and still meet entry requirements for an antidepressant clinical trial based on their persistent symptom severity. 

Augmentation with TMS in partially responsive, depressed patients has also been investigated. In one study of 24 major depressive disorder (MDD) patients, Conca et al. (212) compared an antidepressant plus LF-rTMS (<0.17 Hz, 1.9 T, 10 sessions) with an antidepressant only. Using the Hamilton Depression Rating Scale (HDRS) as the primary outcome measure, the authors reported that the combined treatment was superior to antidepressant monotherapy. 

Three terms beginning with the letter R are used to describe the improvement of a depressed patient after treatment with an antidepressant, namely response, remission, and recovery. The term response generally means that a depressed patient has experienced at least a 50% reduction in symptoms as assessed on a standard psychiatric rating scale such as the Hamilton Depression Rating Scale (Fig. 5—2). This also generally corresponds to a global clinical rating of the patient as much improved or very much improved. Remission, on the other hand, is the term used when essentially all symptoms go away, not just 50% of them (Fig. 5-3). The patient is not better the patient is actually well. If this lasts for 6 to 12 months, remission is then considered to be recovery (Fig. 5—3). 

Moritz S, Meier B, Hand I, Schick M, Jahn H (2004) Dimensional structure of the Hamilton Depression Rating Scale in patients with obsessive-compulsive disorder. Psychiatry Res 125 171-180... 

Angst, J., Scheidegger, P., Stabl, M. 1993, Efficacy of moclobemide in different patient groups. Results of new subscales of the Hamilton Depression Rating Scale, Clin.Neuropharmacol., vol. 16, suppl. 2, pp. S55-S62. 

One would expect that brain lithium concentrations might be related to effects of Uthium. When brain lithium concentrations were measured with Li magnetic resonance spectroscopy, in older subjects (>50 years) brain concentrations correlated with higher somatic symptoms on the Hamilton Depression rating scale and frontal lobe dysfunction [95 ]. 

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