Linked Life Data

16760927

Source:http://linkedlifedata.com/resource/pubmed/id/16760927

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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
2006-10-18
pubmed:abstractText
Approximately one-third of persons with depression do not respond to antidepressant monotherapy. Studies suggest that atypical antipsychotic augmentation may benefit these patients. We investigated the longer-term efficacy of risperidone augmentation of serotonin-selective reuptake inhibitor treatment for resistant depression. In 57 in- and outpatient centers in three countries, we conducted a three-phase study with 4-6 weeks of open-label citalopram monotherapy, 4-6 weeks of open-label risperidone augmentation, and a 24-week double-blind, placebo-controlled discontinuation phase. A total of 489 patients with major depressive disorder and 1-3 documented treatment failures entered the citalopram monotherapy phase (20-60 mg/day). Patients with <50% reduction in HAM-D-17 scores entered the risperidone augmentation phase (0.25-2.0 mg/day). Patients with HAM-D-17< or =7 or CGI-S < or = 2 were randomized to risperidone or placebo augmentation. The primary outcome was time to relapse during the double-blind phase. During citalopram monotherapy, 434 patients had <50% HAM-D-17 reduction; 299 (68.9%) were fully nonresponsive (<25% reduction) and 135 were partially nonresponsive (25-49% reduction). Of the 386 nonresponders who entered the augmentation phase, 243 remitted and 241 entered the double-blind phase. Median time to relapse was 102 days with risperidone augmentation and 85 days with placebo (NS); relapse rates were 53.3 and 54.6%, respectively. In a post hoc analysis of patients fully nonresponsive to citalopram monotherapy, median time to relapse was 97 days with risperidone augmentation and 56 with placebo (p = 0.05); relapse rates were 56.1 and 64.1%, respectively (p < or = 0.05). Open-label risperidone augmentation substantially enhanced response in treatment-resistant patients, but the longer-term benefits of augmentation were not demonstrated in this study.
pubmed:grant
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
0893-133X
pubmed:author
pubmed:issnType
Print
pubmed:volume
31
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2505-13
pubmed:dateRevised
2011-5-18
pubmed:meshHeading
pubmed-meshheading:16760927-Adolescent, pubmed-meshheading:16760927-Adult, pubmed-meshheading:16760927-Aged, pubmed-meshheading:16760927-Aged, 80 and over, pubmed-meshheading:16760927-Antipsychotic Agents, pubmed-meshheading:16760927-Chi-Square Distribution, pubmed-meshheading:16760927-Citalopram, pubmed-meshheading:16760927-Depression, pubmed-meshheading:16760927-Dose-Response Relationship, Drug, pubmed-meshheading:16760927-Double-Blind Method, pubmed-meshheading:16760927-Drug Interactions, pubmed-meshheading:16760927-Drug Resistance, pubmed-meshheading:16760927-Female, pubmed-meshheading:16760927-Humans, pubmed-meshheading:16760927-Male, pubmed-meshheading:16760927-Middle Aged, pubmed-meshheading:16760927-Outcome Assessment (Health Care), pubmed-meshheading:16760927-Proportional Hazards Models, pubmed-meshheading:16760927-Risperidone, pubmed-meshheading:16760927-Serotonin Uptake Inhibitors, pubmed-meshheading:16760927-Time Factors
pubmed:year
2006
pubmed:articleTitle
Effects of risperidone augmentation in patients with treatment-resistant depression: Results of open-label treatment followed by double-blind continuation.
pubmed:affiliation
Department of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. mark.rapaport@cshs.org
pubmed:publicationType
Journal Article, Comparative Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural