Document Detail


The efficacy and safety of aripiprazole as adjunctive therapy in major depressive disorder: a multicenter, randomized, double-blind, placebo-controlled study.
MedLine Citation:
PMID:  17592907     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the efficacy and safety of aripiprazole versus placebo as adjunctive treatment to standard antidepressant therapy (ADT) in patients with major depressive disorder (MDD) who showed an incomplete response to 1 prospective and 1 to 3 historical courses of ADT within the current episode. METHOD: The study comprised a 7- to 28-day screening phase, an 8-week prospective treatment phase, and a 6-week double-blind treatment phase. Patients with DSM-IV-TR-defined MDD were enrolled between June 16, 2004, and April 27, 2006. During prospective treatment, patients received ADT: escitalopram, fluoxetine, paroxetine controlled-release, sertraline, or venlafaxine extended-release, each with single-blind, adjunctive placebo. Incomplete responders continued ADT and were randomly assigned to double-blind, adjunctive placebo or adjunctive aripiprazole (2-15 mg/day with fluoxetine or paroxetine; 2-20 mg/day with all others). The primary efficacy endpoint was the mean change from end of prospective treatment to end of double-blind treatment (week 14, last observation carried forward) in Montgomery-Asberg Depression Rating Scale (MADRS) total score (analysis of covariance). RESULTS: A total of 178 patients were randomly assigned to adjunctive placebo and 184 to adjunctive aripiprazole. Baseline demographics were similar between groups (mean MADRS total score of 26.0). Mean change in MADRS total score was significantly greater with adjunctive aripiprazole (-8.8) than adjunctive placebo (-5.8; p < .001). Adverse events (AEs) that occurred in > or = 10% of patients with adjunctive placebo or adjunctive aripiprazole were akathisia (4.5% vs. 23.1%), headache (10.8% vs. 6.0%), and restlessness (3.4% vs. 14.3%). Discontinuations due to AEs were low with adjunctive placebo (1.7%) and adjunctive aripiprazole (2.2%); only 1 adjunctive aripiprazole-treated patient discontinued due to akathisia. CONCLUSIONS: In patients with MDD who showed an incomplete response to ADT, adjunctive aripiprazole was efficacious and well tolerated. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov identifier NCT00095823.
Authors:
Robert M Berman; Ronald N Marcus; René Swanink; Robert D McQuade; William H Carson; Patricia K Corey-Lisle; Arif Khan
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of clinical psychiatry     Volume:  68     ISSN:  1555-2101     ISO Abbreviation:  J Clin Psychiatry     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-26     Completed Date:  2007-07-19     Revised Date:  2008-09-04    
Medline Journal Info:
Nlm Unique ID:  7801243     Medline TA:  J Clin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  843-53     Citation Subset:  IM    
Affiliation:
Bristol-Myers Squibb Co., Wallingford, Conn. 06492, USA. Robert.Berman@bms.com
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00095823
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MeSH Terms
Descriptor/Qualifier:
Adult
Antidepressive Agents / therapeutic use*
Antipsychotic Agents / adverse effects,  therapeutic use*
Depressive Disorder, Major / drug therapy*
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Male
Middle Aged
Piperazines / adverse effects,  therapeutic use*
Quinolones / adverse effects,  therapeutic use*
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antidepressive Agents; 0/Antipsychotic Agents; 0/Piperazines; 0/Quinolones; 129722-12-9/aripiprazole
Comments/Corrections
Comment In:
J Clin Psychiatry. 2008 Jun;69(6):1021; author reply 1021-2   [PMID:  18684004 ]
Evid Based Ment Health. 2008 Feb;11(1):15   [PMID:  18223050 ]

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