Antipsychotics May Boost Outcomes in Refractory Depression
Adding an antipsychotic to current treatment may improve outcomes in patients with refractory major depressive disorder (MDD), new research suggests. A randomized study of more than 1500 adults with MDD showed that for those whose treatments were augmented with aripiprazole (Abilify, , Otsuka Pharmaceutical Co), remission rates at 12 weeks (the primary endpoint) were "modestly" yet significantly greater than remission rates for participants who were switched to the antidepressant bupropion (multiple brands), and response rates were significantly greater. In addition, for participants who received adjunctive aripiprazole, reductions in depression symptom scores were greater than for participants in a third group for whom bupropion was added to their current antidepressant treatment.
@premomay The researchers enrolled 1522 participants with MDD (85.25% men; mean age, 54.4 years) from 35 US VA health centers. All were randomly assigned to receive aripiprazole in addition to current treatment ("+aripiprazole," n = 505), bupropion in addition to current treatment ("+bupropion," n = 506), or bupropion by itself ("switchers," n = 511) for 12 weeks. Follow-up evaluations were conducted for up to 36 weeks. The primary outcome was remission, defined as a score of 5 or less on the 16-item Quick Inventory of Depressive Symptomatology–Clinician Rated (QIDS-C) on two consecutive visits. Secondary endpoints included response rates, defined as a 50% or greater reduction in QIDS-C score or a rating on the Clinical Global Impression (CGI) scale indicating the patient was much or very much improved; relapse rates during the follow-up phase; and any treatment-related adverse events.