Is extended clonazepam cotherapy of fluoxetine effective for outpatients with major depression?

Smith, Ward T.; Londborg, Peter D.; Glaudin, Vincent; Painter, John R.

doi:10.1016/s0165-0327(01)00352-4

Cited by 59 publications

(36 citation statements)

References 13 publications

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“…Six of these depressed subjects did not receive 1-year post-treatment ratings; five were lost to follow-up and one missed the 1-year follow-up. Remission was defined as at least a 50% decrease from HAM-D 24 baseline score and a score of p10 at the 1-year assessment (Bschor et al, 2002;Bschor et al, 2003;Keller, 2004;Lin et al, 1998;Paykel et al, 1995;Roose and Suthers, 1998;Smith et al, 2002). All subjects were treated with antidepressant medications during the year.…”

Section: Subjectsmentioning

confidence: 99%

Higher 5-HT1A Receptor Binding Potential During a Major Depressive Episode Predicts Poor Treatment Response: Preliminary Data from a Naturalistic Study

Parsey

Olvet

Oquendo

et al. 2006

Neuropsychopharmacol

207

122

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Serotonin 1A (5-HT 1A ) binding potential (BP) as assessed by positron emission tomography (PET) is higher in major depressive disorder (MDD) in association with the higher expressing GG genotype of the 5-HT 1A C-1019G polymorphism. We hypothesize that higher 5-HT 1A BP and the GG genotype predict remission failure on antidepressant treatment. We determined 5-HT 1A BP by PET and 5-HT 1A C-1019G genotype in 43 controls and 22 medication-free MDD subjects. MDD was treated naturalistically and remission was defined as 450% reduction and a score of p10 on the 24 item Hamilton Scale 1 year after initiation of treatment after scanning. Despite equivalent treatment, nonremitters have higher pretreatment cortical BP and the GG genotype is over-represented compared with remitters. Higher 5-HT 1A BP, perhaps due to greater gene expression, may predict antidepressant medication nonremission. The findings should be tested in a controlled prospective treatment study.

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Section: Subjectsmentioning

confidence: 99%

Higher 5-HT1A Receptor Binding Potential During a Major Depressive Episode Predicts Poor Treatment Response: Preliminary Data from a Naturalistic Study

Parsey

Olvet

Oquendo

et al. 2006

Neuropsychopharmacol

207

122

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“…Lormetazepam has been shown to be more effective than placebo in enhancing the antidepressant effect of maprotiline or nortriptyline [128]. Similarly, clonazepam augmentation of fluoxetine was associated with nonsignificantly higher remission rates than placebo augmentation in an 8-week acute trial with 80 depressed patients [129]. A 4-week study on 190 patients with a history of depression and of effective and stable treatment with SSRIs showed that augmentation with the nonbenzodiazepine hypnotic zolpidem was significantly more effective than placebo in treating residual symptoms of insomnia [130].…”

Section: Augmentation Studiesmentioning

confidence: 99%

Current Status of Augmentation and Combination Treatments for Major Depressive Disorder: A Literature Review and a Proposal for a Novel Approach to Improve Practice

Fava

Rush

2006

Psychother Psychosom

138

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Most patients with major depressive disorder (MDD) do not reach symptom remission. These patients with residual symptoms have worse function and worse prognosis than those who remit. Several augmentation and combination treatments are used to either increase the chances of achieving remission or to eliminate/minimize residual depressive symptoms. Evidence for these pharmacological approaches rests primarily on open, uncontrolled studies, and there are clearly not enough controlled studies. Clinicians should carefully weigh these different treatment options to increase their patients’ chances of achieving and sustaining remission from depression. This paper will review the pertinent studies and will propose a novel approach to improve practice involving the use of augmentation or combination strategies at the outset of initial treatment to primarily enhance the chances of remission through synergy and/or a broader spectrum of action. This novel approach could potentially enhance retention and/or increase remission rates since the lack of response with antidepressant monotherapy may lead many depressed patients with little or no benefit to drop out of treatment, precluding the subsequent use of augmentation or combination strategies altogether. In addition, the emergence of certain side-effects (e.g., agitation, insomnia) or the persistence of some initial baseline symptoms (e.g., anxiety, insomnia) may lead to premature discontinuation from monotherapy in the absence of concomitant use of augmenting pharmacological options targeting these symptoms.

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“…Benzodiazepines were co-prescribed in 78 (76%) patients and most common was Clonazepam 35 (12.63%). [14][15][16] Details of the concomitant medications are given in Figure 1. Similar findings were observed by other investigators as well (Mohanta, Manavalan, Prabha, Prasanna).…”

Section: Discussionmentioning

confidence: 99%

Observational study of drug use pattern in indoor patients suffering from major depression admitted in psychiatry department of tertiary care teaching hospital

Thakare

Dubey²

2018

Int J Basic Clin Pharmacol

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Background: Mental illness is associated with high levels of health service utilization and associated costs. India is among one of the countries with the highest number of people suffering from depression. The data on antidepressant drug utilization in India is sparse. Hence, we planned to analyse the drug use pattern in patients of major depression as per the WHO recommended indicators of drug use.Methods: This prospective observational study was done to analyze the prescription pattern of hospital psychiatrist in indoor major depression patients. All the patients admitted in psychiatry indoor patient department (I. P. D.) of Dr. D. Y. Patil Hospital, Navi Mumbai were included.Results: Data of 97 patients was analysed. 55.67% of the cases were from the age group 31-50 years. Total number of antidepressants prescribed was 102(36.82%). Out of antidepressant agents, Selective Serotonin Reuptake Inhibitors (SSRIs) were the most commonly prescribed drugs 70 (68.62%). The most commonly prescribed antidepressant was Sertraline in 35 (34.3%).Conclusions: The findings of our study were similar to those of other studies conducted to evaluate the use of antidepressants.

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Is extended clonazepam cotherapy of fluoxetine effective for outpatients with major depression?

Cited by 59 publications

References 13 publications

Higher 5-HT1A Receptor Binding Potential During a Major Depressive Episode Predicts Poor Treatment Response: Preliminary Data from a Naturalistic Study

Higher 5-HT1A Receptor Binding Potential During a Major Depressive Episode Predicts Poor Treatment Response: Preliminary Data from a Naturalistic Study

Current Status of Augmentation and Combination Treatments for Major Depressive Disorder: A Literature Review and a Proposal for a Novel Approach to Improve Practice

Observational study of drug use pattern in indoor patients suffering from major depression admitted in psychiatry department of tertiary care teaching hospital

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