| Intravenous augmentative citalopram versus clomipramine in partial/nonresponder depressed patients: a short-term, low dose, randomized, placebo-controlled study. | |
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MedLine Citation:
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PMID: 18626267 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of the present study was to evaluate the efficacy of short-term low-dose intravenous augmentative citalopram (10 mg/d) versus clomipramine (25 mg/d) versus placebo in a sample of patients with MDE and partial or no response to selective serotonin reuptake inhibitors (SSRIs). Fifty-four patients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, MDE and partial or no response to SSRIs per os (21-item Hamilton Depression Rating Scale [HAM-D21] score reduction, <50% or < or =25%, respectively, compared with pretreatment scores) were selected and randomized to citalopram (n = 18), clomipramine (n = 18), or placebo (n = 18) intravenous augmentation. The augmentation regimen lasted 5 days during which patients were maintained on their previous treatment with oral SSRIs. Analyses of variance with repeated measures on HAM-D(21), collected daily in blind-raters design, were performed to detect any change of depressive symptoms between the 3 groups. In addition, the number of responders and remitters was computed in the 3 groups of treatment. At end point, a significant treatment effect (F= 4.57; P = 0.015) and time-by-treatment effect (F = 11.22; P < 0.0001) were found on HAM-D21 total scores in favor of citalopram and clomipramine versus placebo, with a superiority of citalopram over clomipramine on overall symptoms (P = 0.05) as well as on anxiety-somatization symptoms (P = 0.027). The number of responders was significantly superior in the active treatment groups versus the placebo group ([chi](2)(2) = 16.36; P < 0.0001). The same result was found, considering the number of remitters ([chi](2)(2) = 13.50; P < 0.0001). Present findings suggest that both clomipramine and citalopram intravenous augmentation at low doses and for a short period are well tolerated and superior to placebo in major depressives with partial or no response to oral SSRIs with a possible superiority of citalopram over clomipramine with regard to anxiety-somatization symptoms. The lack of double-blind conditions and the limited sample size may limit the confidence in the reported results, and larger randomized controlled trials are warranted to confirm the present findings. |
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Authors:
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Alfredo Carlo Altamura; Bernardo Dell'Osso; Massimiliano Buoli; Silvia Zanoni; Emanuela Mundo |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of clinical psychopharmacology Volume: 28 ISSN: 1533-712X ISO Abbreviation: J Clin Psychopharmacol Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-15 Completed Date: 2008-10-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8109496 Medline TA: J Clin Psychopharmacol Country: United States |
Other Details:
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Languages: eng Pagination: 406-10 Citation Subset: IM |
Affiliation:
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Department of Psychiatry, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Antidepressive Agents / administration & dosage*, therapeutic use Citalopram / administration & dosage*, therapeutic use Clomipramine / administration & dosage, therapeutic use Depressive Disorder, Major / drug therapy Drug Administration Schedule Drug Resistance Drug Therapy, Combination Female Humans Injections, Intravenous Male Serotonin Uptake Inhibitors / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Antidepressive Agents; 0/Serotonin Uptake Inhibitors; 303-49-1/Clomipramine; 59729-33-8/Citalopram |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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