Aripiprazole augmentation, antidepressant combination or switching therapy in patients with major depressive disorder who are partial- or non-responsive to current antidepressants: a multi-center, naturalistic study.

Abstract

There has been no studies comparing the clinical benefits of aripiprazole augmentation (AT), antidepressant combination (AC), and switching to a different antidepressant (SW) in patients with major depressive disorder (MDD) patients partially or not responding to an initial antidepressant. AT, AC, or SW was chosen by patients. The primary efficacy measure was the proportion of patients showing an improvement in the Clinical Global Impression-Clinical Benefit (CGI-CB) score at week 8. Secondary efficacy measures included changes in CGI-CB, CGI-Severity (S) and subjective satisfaction scores. Remission and responder analysis were also employed. A total of 295 patients were enrolled. The most preferred strategy was AT (n = 156, 52.9%), followed by AC (n = 93, 31.5%) and SW (n = 46, 15.6%). The improver was significantly higher in AT (74.1%) compared with AC (48.1%; p < 0.001) and similar to SW (73.5%, p = 0.948), whereas no significant difference was found between AC and SW. Similar results were also found in the most secondary endpoint measures proving a superiority of AT over AC without differences between AT and SW. Tolerability profiles were similar across the three groups; however, the mean weight gain for SW (-0.1 kg) was significantly less than that for AC (1.3 kg, p < 0.05). Patients preferred AT to AC or SW when an antidepressant was ineffective in treating their depression. Among the three treatment strategies, overall AT yielded greater clinical benefit than did AC and SW. Adequately powered, well-controlled clinical trials are strongly warranted to confirm our findings due to methodological shortcomings.

• Authors: Changsu Han, Sheng-Min Wang, Ho-Jun Seo, Boung Chul Lee, Hong Jin Jeon, Won Kim, Kyung-Phil Kwak, Chi-Un Pae
• Journal: Journal of psychiatric research (J Psychiatr Res) Vol. 49 Pg. 75-82 (Feb 2014) ISSN: 1879-1379 [Electronic] England
• PMID: 24268719 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemical References

• Antidepressive Agents
• Antipsychotic Agents
• Piperazines
• Quinolones
• Aripiprazole

Topics

• Adult
• Aged
• Analysis of Variance
• Antidepressive Agents (therapeutic use)
• Antipsychotic Agents (therapeutic use)
• Aripiprazole
• Depressive Disorder, Major (drug therapy)
• Drug Substitution (methods)
• Drug Therapy, Combination
• Female
• Humans
• Male
• Middle Aged
• Piperazines (therapeutic use)
• Prospective Studies
• Psychiatric Status Rating Scales
• Quinolones (therapeutic use)