Long-Term Antidepressant Efficacy and Safety of Olanzapine/Fluoxetine Combination

Corya, S.; Andersen, Scott W.; Detke, Holland C.; Kelly, L.S.; Campen, Luann E. Van; Sanger, T.M.; Williamson, D.S.; Dubé, Sanjay

doi:10.4088/jcp.v64n1111

Cited by 69 publications

(73 citation statements)

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“…In particular, Shelton et al (2001) have demonstrated that relatively low doses of olanzapine augment the effects of fluoxetine in depressed patients who were refractory to the selective serotonin reuptake inhibitors monotherapy. Two recent papers extend these clinical data, suggesting that olanzapine-fluoxetine combination shows rapid and sustained improvement in depressive symptoms in patients with major depressive disorder, including treatment-resistant patients (Corya et al, 2003) and that the same drug combination is effective in the treatment of bipolar I depression (Tohen et al, 2003). We have added further evidence to the antidepressant effect of olanzapine by testing the efficacy of the drug in preventing the onset of anhedonia under experimental conditions similar to those employed in the present study (Orsetti et al, 2006).…”

Section: Quetiapine Prevents Anhedoniasupporting

confidence: 51%

Quetiapine Prevents Anhedonia Induced by Acute or Chronic Stress

Orsetti

Canonico

Dellarole

et al. 2007

Neuropsychopharmacol

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The role of atypical antipsychotics as add-on treatments and as primary mood stabilizers in different phases of bipolar disorder is an important current research area. Although in bipolar patients the main therapeutic indication of quetiapine (QTP) is the management of acute mania, several observations suggest that this agent may exert antidepressant as well as antimanic effects. However, in our knowledge, there are no preclinical studies supporting this hypothesis. Thus, the main goal of the present work was to evaluate the putative antidepressant effect of QTP (0.4, 2.0, or 10 mg/kg/day), in comparison to amitriptyline (AMI) (2 or 5 mg/kg/day), in rats exposed to acute or chronic stress. The administration of QTP, 2 mg/kg/day, prevents the onset of anhedonia in rats exposed to a 6-week chronic mild stress (CMS) protocol. The effect of QTP has a slow onset, beginning at week 5, and causes a complete recovery from anhedonia. In this respect, the effect of QTP is similar to that obtained after chronic administration of AMI 2 or 5 mg/kg/day. Our findings also indicate that a 6-week administration of QTP, 2 or 10 mg/kg/day, has protective effects against the onset of anhedonia caused by the exposure to an acute subthreshold stressful event in rats that have previously experienced the CMS procedure. The results suggest that QTP is able to prevent both the transient mood depression caused by acute stress and the long-lasting anhedonic state induced by exposure, over a period of weeks, to a variety of unpredictable mild stressors.

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Section: Quetiapine Prevents Anhedoniasupporting

confidence: 51%

Quetiapine Prevents Anhedonia Induced by Acute or Chronic Stress

Orsetti

Canonico

Dellarole

et al. 2007

Neuropsychopharmacol

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“…Nevertheless, tardive dyskinesia can occur with all antipsychotic agents. The rate of tardive dyskinesia in populations with MDD treated with aripiprazole in the 1-year safety study (0.4%) (Berman et al 2008) was comparable to what has been reported for other atypicals in other populations in long-term studies (0.8%; Correll 2004) and lower than that seen with olanzapine-fl uoxetine combination (1.8%) (Corya et al 2003). All of the cases resolved within 45 days of discontinuing medication.…”

Section: Augmentation Treatment In Mddsupporting

confidence: 60%

Augmentation treatment in major depressive disorder: focus on aripiprazole

Nelson

Pikalov²,

Berman³

2008

NDT

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Major depressive disorder (MDD) is a disabling psychiatric condition for which effective treatment remains an outstanding need. Antidepressants are currently the mainstay of treatment for depression; however, almost two-thirds of patients will fail to achieve remission with initial treatment. As a result, a range of augmentation and combination strategies have been used in order to improve outcomes for patients. Despite the popularity of these approaches, limited data from double-blind, randomized, placebo-controlled studies are available to allow clinicians to determine which are the most effective augmentation options or which patients are most likely to respond to which options. Recently, evidence has shown that adjunctive therapy with atypical antipsychotics has the potential for benefi cial antidepressant effects in the absence of psychotic symptoms. In particular, aripiprazole has shown effi cacy as an augmentation option with standard antidepressant therapy in two, large, randomized, double-blind studies. Based on these effi cacy and safety data, aripiprazole was recently approved by the FDA as adjunctive therapy for MDD. The availability of this new treatment option should allow more patients with MDD to achieve remission and, ultimately, long-term, successful outcomes.

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“…Atypical antipsychotics have been reported to be effective and tolerable in the treatment of refractory patients with major depressive disorder (MDD) without psychotic symptoms, as evidenced by many controlled and open clinical studies [Corya et al, 2003;Papakostas et al, 2004;Viner et al, 2003]. Regarding aripiprazole, there have been some retrospective studies [Barbee et al, 2004;Worthington et al, 2005], a case report [Hellerstein, 2004], and small, prospective, open-label studies [Papakostas et al, 2005;Simon and Nemeroff, 2005].…”

Section: Introductionmentioning

confidence: 99%

Aripiprazole augmentation for treatment of patients with inadequate antidepressants response

Pae¹,

Patkar²,

Jun³

et al. 2007

Depress. Anxiety

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This study evaluated whether or not augmentation with aripiprzazole is beneficial and tolerable to patients with an inadequate response to antidepressants (ADs). Thirteen patients with nonpsychotic major depression, who had failed to respond to an adequate trial of at least one AD, were prescribed aripiprazole (dose, 5-30 mg) for 8 weeks. The dose of their preexisting ADs was not changed. The treatment response was defined as the mean changes in the scores of the Hamilton Depression Rating Scale (HAM-D) from the baseline to the end of treatment. Eleven (84.6%) patients returned for at least one follow-up visit, and 7 (53.8%) patients completed the study. The HAM-D and Clinical Global Impression-Severity (CGI-S) scores decreased significantly from the baseline to the end of treatment by 53.8% and 56.0%, respectively (Z = -2.937, P =.003; Z = -2.961, P =.003). Seven (63.6%) patients showed a > or = 50% reduction in the HAM-D score at the end of treatment. Three (27.3%) patients met the remission criteria at the end of treatment. There were no serious side effects. Despite the high dropout rate in this open study, aripiprazole appears to be reasonably effective and tolerated as an augmentation strategy in conjunction with conventional ADs treatment in patients with an inadequate AD response. These results highlight the potential benefits of aripiprazole for these patients. However, adequately powered, randomized, controlled trials are needed to confirm these results.

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Long-Term Antidepressant Efficacy and Safety of Olanzapine/Fluoxetine Combination

Cited by 69 publications

References 0 publications

Quetiapine Prevents Anhedonia Induced by Acute or Chronic Stress

Quetiapine Prevents Anhedonia Induced by Acute or Chronic Stress

Augmentation treatment in major depressive disorder: focus on aripiprazole

Aripiprazole augmentation for treatment of patients with inadequate antidepressants response

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