Lithium Augmentation Versus Citalopram Combination in Imipramine-Resistant Major Depression: A 10-Week Randomized Open-Label Study.
Adult
Aged
Antidepressive Agents
/ administration & dosage
Antidepressive Agents, Tricyclic
/ administration & dosage
Citalopram
/ administration & dosage
Depressive Disorder, Major
/ drug therapy
Drug Therapy, Combination
Female
Humans
Imipramine
/ administration & dosage
Lithium Compounds
/ administration & dosage
Longitudinal Studies
Male
Middle Aged
Psychiatric Status Rating Scales
Treatment Outcome
Journal
Journal of clinical psychopharmacology
ISSN: 1533-712X
Titre abrégé: J Clin Psychopharmacol
Pays: United States
ID NLM: 8109496
Informations de publication
Date de publication:
Historique:
pubmed:
30
3
2019
medline:
10
8
2019
entrez:
30
3
2019
Statut:
ppublish
Résumé
According to available international clinical guides, tricyclic antidepressants are our first- or second-line treatment of choice for severe unipolar major depression. However, the therapeutic option after an unsuccessful response to a tricyclic antidepressant drug in unipolar major depression is still unclear. This 10-week randomized open-label study assessed the effectiveness of add-on lithium (adjusted to plasma levels) compared with add-on citalopram (30 mg/d) in 104 severe unipolar major depressive patients after a 10-week unsuccessful imipramine (adjusted to plasma level). Efficacy analyses examined changes in the severity of depression symptoms from baseline visit to endpoint and the comparative remission rate between treatment subgroups. The randomized sample consisted of 104 imipramine-resistant severe unipolar major depressed patients. Both, the percentage of remitters (40.4% vs 21.1%, P = 0.034) and the mean reduction of the Hamilton Depression Rating Scale score (58.8% vs 42.5%, P = 0.005) were significantly greater in the add-on citalopram subgroup at endpoint visit. Although we should be cautious about generalizing these results to patients with a less severe unipolar major episode, results from the present study suggest that add-on citalopram is a very effective treatment option in unipolar major depressive episodes after an unsuccessful imipramine regimen.
Sections du résumé
PURPOSE/BACKGROUND
OBJECTIVE
According to available international clinical guides, tricyclic antidepressants are our first- or second-line treatment of choice for severe unipolar major depression. However, the therapeutic option after an unsuccessful response to a tricyclic antidepressant drug in unipolar major depression is still unclear.
METHODS/PROCEDURES
METHODS
This 10-week randomized open-label study assessed the effectiveness of add-on lithium (adjusted to plasma levels) compared with add-on citalopram (30 mg/d) in 104 severe unipolar major depressive patients after a 10-week unsuccessful imipramine (adjusted to plasma level). Efficacy analyses examined changes in the severity of depression symptoms from baseline visit to endpoint and the comparative remission rate between treatment subgroups.
FINDINGS/RESULTS
RESULTS
The randomized sample consisted of 104 imipramine-resistant severe unipolar major depressed patients. Both, the percentage of remitters (40.4% vs 21.1%, P = 0.034) and the mean reduction of the Hamilton Depression Rating Scale score (58.8% vs 42.5%, P = 0.005) were significantly greater in the add-on citalopram subgroup at endpoint visit.
IMPLICATIONS/CONCLUSIONS
CONCLUSIONS
Although we should be cautious about generalizing these results to patients with a less severe unipolar major episode, results from the present study suggest that add-on citalopram is a very effective treatment option in unipolar major depressive episodes after an unsuccessful imipramine regimen.
Identifiants
pubmed: 30925498
doi: 10.1097/JCP.0000000000001024
doi:
Substances chimiques
Antidepressive Agents
0
Antidepressive Agents, Tricyclic
0
Lithium Compounds
0
Citalopram
0DHU5B8D6V
Imipramine
OGG85SX4E4
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Langues
eng