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Long-term antidepressant efficacy and safety of olanzapine/fluoxetine combination: a 76-week open-label study.
- Source :
-
The Journal of clinical psychiatry [J Clin Psychiatry] 2003 Nov; Vol. 64 (11), pp. 1349-56. - Publication Year :
- 2003
-
Abstract
- Background: The olanzapine/fluoxetine combination has demonstrated effectiveness in treatment-resistant depression (TRD). Although this combination is being used by prescribers, this is the first study to examine long-term use. Long-term efficacy and safety were therefore investigated in a group of patients with major depressive disorder (MDD) with and without TRD.<br />Method: 560 patients who met DSM-IV diagnostic criteria for MDD were enrolled in this 76-week, open-label study (Feb. 2000-July 2002). The Montgomery-Asberg Depression Rating Scale (MADRS) total score was the primary efficacy measure. Safety was assessed via adverse events, vital signs, laboratory analytes, electrocardiography, and extrapyramidal symptom measures.<br />Results: MADRS mean total scores decreased 7 points from baseline (31.6 [N = 552]) at 1/2 week of treatment, 11 points at 1 week of treatment, and 18 points at 8 weeks of treatment. This effect was maintained to endpoint with a mean decrease of 22 points at 76 weeks. Response and remission rates for the total sample were high (62% and 56%, respectively), and the relapse rate was low (15%). Response, remission, and relapse rates for TRD patients (N = 145) were 53%, 44%, and 25%, respectively. The most frequently reported adverse events were somnolence, weight gain, dry mouth, increased appetite, and headache. At endpoint, there were no clinically meaningful changes in vital signs, laboratory analytes, or electrocardiography. There were no significant increases on any measure of extrapyramidal symptoms.<br />Conclusions: The olanzapine/fluoxetine combination showed rapid, robust, and sustained improvement in depressive symptoms in patients with MDD, including patients with TRD. The long-term safety profile of the combination was similar to that of its component monotherapies.
- Subjects :
- Adult
Benzodiazepines
Depressive Disorder psychology
Drug Administration Schedule
Drug Resistance
Drug Therapy, Combination
Female
Fluoxetine administration & dosage
Fluoxetine adverse effects
Humans
Male
Middle Aged
Olanzapine
Pirenzepine administration & dosage
Pirenzepine adverse effects
Selective Serotonin Reuptake Inhibitors administration & dosage
Selective Serotonin Reuptake Inhibitors adverse effects
Severity of Illness Index
Treatment Outcome
Depressive Disorder drug therapy
Fluoxetine pharmacology
Pirenzepine analogs & derivatives
Pirenzepine pharmacology
Selective Serotonin Reuptake Inhibitors pharmacology
Subjects
Details
- Language :
- English
- ISSN :
- 0160-6689
- Volume :
- 64
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- The Journal of clinical psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 14658950
- Full Text :
- https://doi.org/10.4088/jcp.v64n1111