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Effexor + Abilify for TRD - Recent Harvard study.

Posted by SLS on October 8, 2009, at 10:11:36

Effectiveness study of venlafaxine-XR combined with aripiprazole for chronic or recurrent major depressive disorder:

http://www.informaworld.com/smpp/content~content=a915575415~db=all~jumptype=rss


Authors: Andrew A. Nierenberg a; Madhukar H. Trivedi b; Bradley N. Gaynes c; Jeff Mitchell de; Lori L. Davis f; Mustafa M. Husain b; Stephen R. Wisniewski g; Maurizio Fava a; Diane Warden b; James F. Luther g; Adrienne O. van Nieuwenhuizen a; David W. Morris b; Richard C. Shelton h; A. John Rush b
Affiliations: a Harvard Medical School, Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
b Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
c University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
d University of Oklahoma College of Medicine, Tulsa
e Laureate Psychiatric Clinic and Hospital, Tulsa, Oklahoma, USA
f School of Medicine, University of Alabama; VA Medical Center, Tuscaloosa, Alabama, USA
g Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
h Vanderbilt University, Nashville, Tennessee, USA


Abstract:

Objective: Although the second-generation antipsychotic, aripiprazole (ARI), has been approved as an adjunct for treatment-resistant major depressive disorder (MDD), neither ARI nor any second-generation antipsychotic has been assessed in combination with an antidepressant at the initiation of a treatment trial for non-treatment-resistant MDD. The aim of the present study was therefore to assess the safety, tolerability, and remission rate in the treatment of MDD using the specific combination of venlafaxine-XR (VEN-XR) and ARI in a generalizable, difficult-to-treat group with chronic or recurrent MDD.

Methods: Self-declared participants in primary care or psychiatric settings who had chronic or recurrent MDD and a minimum score of 14 on the 17-item Hamilton Rating Scale for Depression were included. Up to 12 weeks of open treatment with the combination of VEN-XR and ARI was provided. Participants began with VEN-XR, and ARI was added at week 2. Maximum allowable doses were 300 mg day-1 for venlafaxine-XR and 30 mg day-1 for ARI. Remission was defined as ≤ 5 on the 16-item Quick Inventory of Depressive Symptomatology-Self-report (QIDS-SR16).

Results: Fifty outpatients with non-psychotic MDD were enrolled (mean age = 43±11 years; 38% male; QIDS-SR16=15±3). Mean exit dose of VEN-XR was 227±97 mg day-1, and the mean exit dose of ARI was 11±7 mg day-1. The combination was well tolerated; 16% of participants discontinued due to side-effects. Approximately 70% achieved remission at some point during the trial, and 66% achieved remission at study exit.

Conclusions: To the best of the authors' knowledge this is the first study to combine an antidepressant and second-generation antipsychotic at the beginning of a treatment trial for chronic or recurrent non-treatment resistant MDD. VEN-XR and ARI combination appears to warrant further study in controlled trials.

- Scott

 

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poster:SLS thread:920182
URL: http://www.dr-bob.org/babble/20091001/msgs/920182.html