Aripiprazole augmentation, antidepressant combination or switching therapy in patients with major depressive disorder who are partial- or non-responsive to current antidepressants: A multi-center, naturalistic study

Changsu Han, Sheng Min Wang, Ho Jun Seo, Boung Chul Lee, Hong Jin Jeon, Won Kim, Kyung Phil Kwak, Chi Un Pae

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

There has been no studies comparing the clinical benefits of aripiprazole augmentation (AT), antidepressant combination (AC), and switching to a different antidepressant (SW) in patients with major depressive disorder (MDD) patients partially or not responding to an initial antidepressant. AT, AC, or SW was chosen by patients. The primary efficacy measure was the proportion of patients showing an improvement in the Clinical Global Impression-Clinical Benefit (CGI-CB) score at week 8. Secondary efficacy measures included changes in CGI-CB, CGI-Severity (S) and subjective satisfaction scores. Remission and responder analysis were also employed. A total of 295 patients were enrolled. The most preferred strategy was AT (n=156, 52.9%), followed by AC (n=93, 31.5%) and SW (n=46, 15.6%). The improver was significantly higher in AT (74.1%) compared with AC (48.1%; p<0.001) and similar to SW (73.5%, p=0.948), whereas no significant difference was found between AC and SW. Similar results were also found in the most secondary endpoint measures proving a superiority of AT over AC without differences between AT and SW. Tolerability profiles were similar across the three groups; however, the mean weight gain for SW (-0.1kg) was significantly less than that for AC (1.3kg, p<0.05). Patients preferred AT to AC or SW when an antidepressant was ineffective in treating their depression. Among the three treatment strategies, overall AT yielded greater clinical benefit than did AC and SW. Adequately powered, well-controlled clinical trials are strongly warranted to confirm our findings due to methodological shortcomings.

Original languageEnglish
Pages (from-to)75-82
Number of pages8
JournalJournal of Psychiatric Research
Volume49
Issue number1
DOIs
Publication statusPublished - 2014 Feb

Keywords

  • Augmentation
  • Combination
  • Depression
  • Switching

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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