Switch to
| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
|
| pubmed:dateCreated |
1997-10-21
|
| pubmed:abstractText |
In depression that is resistant to tricyclic antidepressant (TCA) therapy, the substitution of a selective serotonin re-uptake inhibitor (SSRI), clomipramine, or a monoamine oxidase (MAO) inhibitor has been recommended. However, adding an additional antidepressant medication from a different drug class may produce even more rapid efficacy. In this regard, the combination of a MAO inhibitor or a SSRI plus a TCA has been shown to be of value in treatment-resistant depression (TRD). In this report, we examined the efficacy of clomipramine augmentation in 20 patients who failed to respond to either a MAO inhibitor or fluoxetine therapy for at least a 6-week period, and compared this to a third group given MAO inhibitor plus a conventional TCA. Two out of 9 (22%) MAO inhibitor/clomipramine patients and 4 out of 11 (36%) fluoxetine/clomipramine patients improved (Fisher's Exact test, P = ns), compared to 3 out of 7 (43%) patients taking MAO inhibitor/TCA (P = ns). However, the MAO inhibitor/clomipramine group experienced significantly more adverse events which necessitated stopping treatment (56%) when compared to the fluoxetine/clomipramine (9%) and compared to the MAO inhibitor/TCA group (0%) (chi 2 = 8.9, df = 2, P < 0.05). These adverse events included several cases of serotonin syndrome of mild to moderate severity. These observations indicate that clomipramine augmentation of a failed MAO inhibitor trial is of marginal efficacy (compared to augmentation with a conventional TCA) and should be employed with extreme caution.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Antidepressive Agents, Tricyclic,
http://linkedlifedata.com/resource/pubmed/chemical/Clomipramine,
http://linkedlifedata.com/resource/pubmed/chemical/Monoamine Oxidase Inhibitors,
http://linkedlifedata.com/resource/pubmed/chemical/Serotonin,
http://linkedlifedata.com/resource/pubmed/chemical/Serotonin Uptake Inhibitors
|
| pubmed:status |
MEDLINE
|
| pubmed:issn |
1091-4269
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
5
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
84-90
|
| pubmed:dateRevised |
2006-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:9262938-Adult,
pubmed-meshheading:9262938-Aged,
pubmed-meshheading:9262938-Akathisia, Drug-Induced,
pubmed-meshheading:9262938-Analysis of Variance,
pubmed-meshheading:9262938-Antidepressive Agents, Tricyclic,
pubmed-meshheading:9262938-Chi-Square Distribution,
pubmed-meshheading:9262938-Clomipramine,
pubmed-meshheading:9262938-Cross-Sectional Studies,
pubmed-meshheading:9262938-Depressive Disorder,
pubmed-meshheading:9262938-Drug Interactions,
pubmed-meshheading:9262938-Drug Resistance,
pubmed-meshheading:9262938-Drug Therapy, Combination,
pubmed-meshheading:9262938-Female,
pubmed-meshheading:9262938-Humans,
pubmed-meshheading:9262938-Male,
pubmed-meshheading:9262938-Mental Disorders,
pubmed-meshheading:9262938-Middle Aged,
pubmed-meshheading:9262938-Monoamine Oxidase Inhibitors,
pubmed-meshheading:9262938-Prospective Studies,
pubmed-meshheading:9262938-Retrospective Studies,
pubmed-meshheading:9262938-Serotonin,
pubmed-meshheading:9262938-Serotonin Uptake Inhibitors,
pubmed-meshheading:9262938-Syndrome,
pubmed-meshheading:9262938-Treatment Outcome
|
| pubmed:year |
1997
|
| pubmed:articleTitle |
Clomipramine augmentation in treatment-resistant depression.
|
| pubmed:affiliation |
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, USA.
|
| pubmed:publicationType |
Journal Article,
Clinical Trial,
Research Support, Non-U.S. Gov't
|