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Pilot study of augmentation with aripiprazole for incomplete response in late-life depression: getting to remission.
- Source :
-
The Journal of clinical psychiatry [J Clin Psychiatry] 2009 Feb; Vol. 70 (2), pp. 208-13. Date of Electronic Publication: 2009 Feb 10. - Publication Year :
- 2009
-
Abstract
- Objective: To determine the feasibility and safety of aripiprazole augmentation for incomplete response to sequential selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) pharmacotherapy in late-life depression.<br />Method: This study was a 12-week, open-label pilot study of 24 patients (recruited from June 1, 2006, to June 1, 2007) aged 65 years and above (mean, 73.9 years) diagnosed with major depressive disorder (MDD) (according to DSM-IV) who responded partially (17-item Hamilton Rating Scale for Depression [HAM-D-17] score of 11 to 15) or not at all (HAM-D score > 15) to a 16-week trial of escitalopram (up to 20 mg/day), followed by either duloxetine (up to 120 mg/day) or venlafaxine (up to 225 mg/day) for 12 weeks. Subjects received 2.5 to 15 mg per day of adjunctive aripiprazole (mean dose, 9.0 mg/day) for 12 weeks. The criterion for remission during treatment with aripiprazole was a HAM-D score < or = 10 for 2 consecutive weeks.<br />Results: Of 24 subjects in the intent-to-treat study group, 19 completed 12 weeks of augmentation with aripiprazole, 12 of 24 (50%) met criteria for remission, and 2 of 24 discontinued due to side effects (sedation, akathisia). The mean (SD) HAM-D score decreased significantly by 6.4 (5.8) points (paired t test for means, p < .01, df = 16). There were no relapses among the 12 subjects who participated in continuation treatment over a median period of 27.6 weeks.<br />Conclusions: In older adults with MDD with incomplete response to SSRI and SNRI pharmacotherapy, aripiprazole was well tolerated, and symptoms of depression improved significantly during treatment with aripiprazole. A randomized, double-blind, placebo-controlled trial of adjunctive aripiprazole for incomplete response in late-life depression is warranted to further evaluate benefit and risk.<br />Trial Registration: clinicaltrials.gov Identifier: NCT00177671.<br /> (Copyright 2009 Physicians Postgraduate Press, Inc.)
- Subjects :
- Aged
Aged, 80 and over
Antidepressive Agents adverse effects
Antipsychotic Agents adverse effects
Aripiprazole
Citalopram adverse effects
Cyclohexanols adverse effects
Depressive Disorder, Major diagnosis
Depressive Disorder, Major psychology
Dose-Response Relationship, Drug
Drug Therapy, Combination
Duloxetine Hydrochloride
Feasibility Studies
Female
Humans
Male
Personality Inventory
Pilot Projects
Piperazines adverse effects
Quinolones adverse effects
Thiophenes adverse effects
Venlafaxine Hydrochloride
Antidepressive Agents therapeutic use
Antipsychotic Agents therapeutic use
Citalopram therapeutic use
Cyclohexanols therapeutic use
Depressive Disorder, Major drug therapy
Piperazines therapeutic use
Quinolones therapeutic use
Thiophenes therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1555-2101
- Volume :
- 70
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of clinical psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 19210951
- Full Text :
- https://doi.org/10.4088/jcp.07m03805