Combining Medications to Enhance Depression Outcomes (CO-MED): Acute and Long-Term Outcomes of a Single-Blind Randomized Study

Rush, A. John; Trivedi, Madhukar H.; Stewart, Jonathan W.; Nierenberg, Andrew A.; Fava, Maurizio; Kurian, Benji T.; Warden, Diane; Morris, David W.; Luther, James F.; Husain, Mustafa M.; Cook, Ian A.; Shelton, Richard C.; Lesser, Ira M.; Kornstein, Susan G.; Wisniewski, Stephen R.

doi:10.1176/appi.ajp.2011.10111645

Cited by 311 publications

(234 citation statements)

References 45 publications

(61 reference statements)

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“…All patients received selective serotonin reuptake inhibitor (SSRI) type antidepressants at the minimum effective dose (fluoxetine 20 mg/day, paroxetine 20 mg/day, sertraline 50 mg/ day, citalopram 20 mg/day or escitalopram 10 mg/day, consistent with other studies 21,22 ), empirically prescribed according to the clinical judgement of the treating psychiatrist (W.H.K. and Y.C.Y.).…”

Section: Treatmentmentioning

confidence: 99%

Resting-state brain activation correlates with short-time antidepressant treatment outcome in drug-naïve patients with major depressive disorder

Wang

Kuang

et al. 2014

J Int Med Res

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Objective: A resting-state functional magnetic resonance imaging study (fMRI) to investigate pretreatment regional differences in brain function, in patients with early treatment responsive (ERD) and early treatment nonresponsive (END) major depressive disorder (MDD). Methods: Patients with MDD and healthy control subjects underwent fMRI. Intrinsic neural activity at baseline was evaluated via amplitude of low-frequency fluctuations (ALFF). Antidepressant treatment was initiated after MRI. All patients received selective serotonin reuptake inhibitor type antidepressants at the minimum effective dose. Results: There were significant differences in brain activity between patients (n ¼ 56) and control subjects (n ¼ 33). Brain activity in patients with ERD (n ¼ 26) differed from those with END (n ¼ 30) in the lingual gyrus and cerebellum. There was a significantly correlation between activity in these regions and disease duration in patients with ERD, and with amelioration of depressive symptoms in patients with END. Conclusions: Brain regions related to the neural mechanism of MDD early treatment outcome were identified. These regions may have important implications for the treatment of MDD.

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Section: Treatmentmentioning

confidence: 99%

Resting-state brain activation correlates with short-time antidepressant treatment outcome in drug-naïve patients with major depressive disorder

Wang

Kuang

et al. 2014

J Int Med Res

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“…However, previous placebo controlled clinical studies along with the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) [4] and Combining Medications to Enhance Depression Outcomes (CO-MED) [5] trials have clearly demonstrated limited therapeutic outcomes with appropriate antidepressant treatments in patients with MDD. In particular, lower response (remission) and higher relapse rates were clearly observed among those who required additional treatment steps in the STAR*D trial [4].…”

Section: Introductionmentioning

confidence: 99%

Clinical Issues in Use of Atypical Antipsychotics for Depressed Patients

Pae

Patkar

2013

CNS Drugs

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Major depressive disorder (MDD) is a chronic, recurrent mental disease that causes serious disability. Because currently available antidepressants have limited efficacy with respect to response and remission in patients with MDD, clinicians must choose the best available treatment interventions for patients who do not respond to initial antidepressant treatment. The existing literature demonstrates that augmentation with atypical antipsychotics (AAs) shows higher response and remission rates compared with antidepressant monotherapy, but is associated with more withdrawals due to adverse events. In this paper, specific clinical issues in the use of AA augmentation for patients with MDD are briefly discussed. Given the limited information and clinical knowledge on the proper and effective use of AAs for MDD, future research should focus on practical clinical issues that can be commonly seen in routine practice but have not been addressed yet. This is because the use of AAs is likely to expand as there is good evidence for their effectiveness and tolerability as augmentation therapy for patients with MDD.

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“…Study of combination therapy could also be informative, such as mirtazapine or buproprion in addition to an SSRI, as this strategy might entail a more benign side effect profile than expected from some of the augmenting agents such as lithium or SGAs. However, a large recent study in a mixed-age population did not demonstrate benefit from two AD combination strategies compared to SSRI monotherapy (54).…”

Section: Discussionmentioning

confidence: 92%

Going Beyond Antidepressant Monotherapy for Incomplete Response in Nonpsychotic Late-Life Depression: A Critical Review

Maust

Oslin

Thase

2013

The American Journal of Geriatric Psychiatry

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Many older adults with Major Depressive Disorder (MDD) do not respond to antidepressant monotherapy. While there are evidence-based treatment options to support treatment beyond monotherapy for adults, the evidence for such strategies specifically in late-life MDD is relatively scarce. This review examines the published data describing strategies for antidepressant augmentation or acceleration studied specifically in older adults, including lithium, stimulants, and second-generation antipsychotics. In addition, the authors suggest strategies for future research, such as study of specific agents, refining understanding of the impact of medical or cognitive comorbidity in late-life depression, and comparative effectiveness to examine methods already used in clinical practice.

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Combining Medications to Enhance Depression Outcomes (CO-MED): Acute and Long-Term Outcomes of a Single-Blind Randomized Study

Abstract: Neither medication combination outperformed monotherapy. The combination of extended-release venlafaxine plus mirtazapine may have a greater risk of adverse events.

Cited by 311 publications

References 45 publications

Resting-state brain activation correlates with short-time antidepressant treatment outcome in drug-naïve patients with major depressive disorder

Resting-state brain activation correlates with short-time antidepressant treatment outcome in drug-naïve patients with major depressive disorder

Clinical Issues in Use of Atypical Antipsychotics for Depressed Patients

Going Beyond Antidepressant Monotherapy for Incomplete Response in Nonpsychotic Late-Life Depression: A Critical Review

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