An Integrated Analysis of Olanzapine/Fluoxetine Combination in Clinical Trials of Treatment-Resistant Depression

Trivedi, Madhukar H.; Thase, Michael E.; Osuntokun, Olawale; Henley, David; Case, Michael; Watson, Stanley W.; Campbell, Giedra; Corya, S.

doi:10.4088/jcp.08m04064

Cited by 56 publications

(76 citation statements)

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“…98 patients met criteria for assignment to one of the 4 treatment groups (phase II): 1) Lithium-augmentation (LiAugm), 2) switch of antidepressants (AD-Switch), 3) combination of antidepressants (AD-Comb), 4) augmentation with SGA (SGA-Augm). Criteria for enrolment into analysis were: patients had to have an adequate antidepressant monotherapeutic treatment in phase I according to duration (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) To assess the severity of depressive symptoms, clinician-rated and self-rating instruments were used at admission and at discharge (t1 and t2). Treatment groups were as heterogeneous as they normally appear in clinical practice.…”

Section: Assignmentmentioning

confidence: 99%

“…Bauer et al (2009) found response rates of 55 % for augmentation after nonresponse to antidepressant monotherapy [ 26 ] . For antidepressant augmentation with aripiprazole [ 27 ] and olanzapine [ 28 ] , response rates were 33.7 % and 25 %, respectively. In the metaanalysis of Nelson and Papakostas (2009) overall effi cacy of augmentation with SGA in treatment-resistant depression has been proven and is in line with the data of our naturalistic study.…”

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confidence: 99%

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Comparing Augmentation with Non-Antidepressants over Sticking to Antidepressants after Treatment Failure in Depression: A Naturalistic Study

Köhler

Unger²,

Hoffmann³

et al. 2012

Pharmacopsychiatry

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Introduction: Non-response to an antidepressant monotherapy in unipolar depression is quite common. Therefore strategies for subsequent treatment steps are necessary. However, there is a lack of direct comparisons of these different strategies. In this naturalistic study we compared the outcome to different strategies after failure of the primary antidepressant treatment. Methods: Failure of primary antidepressant monotherapy occurred in 135 patients. 98 of these patients have been administered 4 treatment strategies of the physicians? choice: lithium augmentation (Li-Augm), switching to another antidepressant (AD-Switch), combination of 2 antidepressants (AD-Comb) or augmentation with second generation antipsychotic (SGA-Augm). Primary outcome measure was the 17-item Hamilton rating scale for depression (HRSD). Results: Patients who received Li-Augm or augmentation with SGAs showed significantly greater improvement in HRSD and BDI compared to patients with antidepressant switch or antidepressant combination. Remission rates for Li-Augm and SGA-Augm were 89.3% and 86.2% compared to 40.7% for AD-Switch and 42.9% for AD-Comb. Discussion: Changing to another pharmacological class (Li-Augm or augmentation with SGAs) showed better treatment results than sticking to the class of antidepressants (AD-Switch and AD-Comb) after primary failure in response to antidepressant monotherapy in unipolar depression. The lack of randomization and absence of a non-response definition are design flaws. Controlled studies are required to confirm the findings of this trial.

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Section: Assignmentmentioning

confidence: 99%

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confidence: 99%

Comparing Augmentation with Non-Antidepressants over Sticking to Antidepressants after Treatment Failure in Depression: A Naturalistic Study

Köhler

Unger²,

Hoffmann³

et al. 2012

Pharmacopsychiatry

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“…Regarding tolerability, the most common adverse events were metabolic abnormalities including weight gain, altered glucose levels, altered cholesterol levels and increased appetite. When the data were pooled, a clinically significant weight gain of more than 7 % was observed in 40 % of the OFC group, with a mean weight change from baseline of 4.42 kg, which was significantly different from fluoxetine monotherapy [19]. The mean change in glucose level at endpoint for the OFC group (?7.92 mg/dl) was significantly higher than that in the fluoxetine-alone group (?1.62 mg/dl).…”

Section: Olanzapinementioning

confidence: 97%

“…1). The data were extracted from nine studies that had all data for the rate of remission, discontinuation due to adverse events and most common adverse effects in each SGA [7,9,19,[22][23][24][25][26]. As for treatment efficacy, the NNT was six for risperidone, eight for aripiprazole, nine for quetiapine and 13 for olanzapine.…”

Section: Risk Benefit Analysismentioning

confidence: 99%

“…1 The number needed to treat (remission rate) and number needed to harm (rates of discontinuation due to adverse events and most common side effects) of each drug (%). Pooled data from controlled trials of olanzapine [19], risperidone [24][25][26], quetiapine [20,22], aripiprazole [7][8][9]. The Cochran data [6] and data in a metaanalysis [5] were referred.…”

Section: Risk Benefit Analysismentioning

confidence: 99%

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Augmentation Treatments with Second-generation Antipsychotics to Antidepressants in Treatment-resistant Depression

Kato

Chang

2013

CNS Drugs

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Various classes of antidepressants have been used in the treatment of major depressive disorder (MDD); however, the efficacy of these treatments remains uncertain. A number of well-controlled clinical trials, meta-analyses and practical clinical studies have found that approximately 30 % of MDD patients remit following antidepressant treatment, leaving approximately 70 % of patients with significant residual symptoms. In these latter patients with what is considered treatment-resistant MDD, typical antipsychotics have sometimes been administered in order to augment the antidepressant effects but safety and tolerability concerns significantly reduce their usage in MDD patients. The advent of second-generation antipsychotics (SGAs), which have diverse pharmacodynamic profiles relative to antidepressants, has dramatically increased the usage of such drugs for patients with MDD. Recently, SGAs such as aripiprazole, quetiapine and olanzapine in combination with fluoxetine have been approved for the treatment of MDD, especially in the case of treatment resistance. This article reviews the efficacy and tolerability of SGA augmentation when added to antidepressant therapy for treatment-resistant MDD patients in acute phase studies published to date.

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Major Depressive Disorder and Bipolar Disorder: Differentiating Features and Contemporary Treatment Approaches

Muneer

2017

Understanding Depression

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An Integrated Analysis of Olanzapine/Fluoxetine Combination in Clinical Trials of Treatment-Resistant Depression

Cited by 56 publications

References 0 publications

Comparing Augmentation with Non-Antidepressants over Sticking to Antidepressants after Treatment Failure in Depression: A Naturalistic Study

Comparing Augmentation with Non-Antidepressants over Sticking to Antidepressants after Treatment Failure in Depression: A Naturalistic Study

Augmentation Treatments with Second-generation Antipsychotics to Antidepressants in Treatment-resistant Depression

Major Depressive Disorder and Bipolar Disorder: Differentiating Features and Contemporary Treatment Approaches

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