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A randomized, placebo-controlled trial of risperidone augmentation for patients with difficult-to-treat unipolar, non-psychotic major depression.
J Psychiatr Res 2009; 43(3):205-14JP

Abstract

OBJECTIVE

Patients (30-50%) with non-psychotic major depression will not respond despite an adequate trial of antidepressant medication. This study evaluated risperidone as an augmenting agent for patients who failed or only partially responded to an adequate trial of an antidepressant medication.

METHOD

Ninety-seven patients with unipolar non-psychotic major depression who were not responsive to antidepressant monotherapy were randomized to risperidone (0.5-3mg/day) or placebo augmentation in a four-week, double-blind, placebo controlled treatment trial. The primary outcome measure was remission defined by a score of < or =10 on the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcomes measures were the Hamilton Rating Scale for Depression, the Clinician Global Impression of Severity scale and the overall satisfaction item of the Quality of Life and Enjoyment Questionnaire.

RESULTS

Subjects in both treatment groups improved significantly over time. The odds of remitting were significantly better for patients in the risperidone vs. placebo arm (OR=3.33, p=.011). At the end of 4 weeks of treatment 52% of the risperidone augmentation group remitted (MADRS< or =10) compared to 24% of the placebo augmentation group (CMH(1)=6.48, p=.011), but the two groups were converging. Patients in the risperidone group also reported significantly more improvement in quality-of-life than patients in the placebo group. There were no between-group differences in the number of adverse events reported, however, weight gain was significantly higher in the group receiving risperidone.

CONCLUSION

Augmentation of an antidepressant with risperidone for patients with difficult-to-treat depression leads to more rapid response and a higher remission rate and better quality-of-life.

Authors+Show Affiliations

Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, United States. GKeitner@Lifespan.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18586273

Citation

Keitner, Gabor I., et al. "A Randomized, Placebo-controlled Trial of Risperidone Augmentation for Patients With Difficult-to-treat Unipolar, Non-psychotic Major Depression." Journal of Psychiatric Research, vol. 43, no. 3, 2009, pp. 205-14.
Keitner GI, Garlow SJ, Ryan CE, et al. A randomized, placebo-controlled trial of risperidone augmentation for patients with difficult-to-treat unipolar, non-psychotic major depression. J Psychiatr Res. 2009;43(3):205-14.
Keitner, G. I., Garlow, S. J., Ryan, C. E., Ninan, P. T., Solomon, D. A., Nemeroff, C. B., & Keller, M. B. (2009). A randomized, placebo-controlled trial of risperidone augmentation for patients with difficult-to-treat unipolar, non-psychotic major depression. Journal of Psychiatric Research, 43(3), pp. 205-14. doi:10.1016/j.jpsychires.2008.05.003.
Keitner GI, et al. A Randomized, Placebo-controlled Trial of Risperidone Augmentation for Patients With Difficult-to-treat Unipolar, Non-psychotic Major Depression. J Psychiatr Res. 2009;43(3):205-14. PubMed PMID: 18586273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized, placebo-controlled trial of risperidone augmentation for patients with difficult-to-treat unipolar, non-psychotic major depression. AU - Keitner,Gabor I, AU - Garlow,Steven J, AU - Ryan,Christine E, AU - Ninan,Philip T, AU - Solomon,David A, AU - Nemeroff,Charles B, AU - Keller,Martin B, Y1 - 2008/06/30/ PY - 2007/10/11/received PY - 2008/05/02/revised PY - 2008/05/13/accepted PY - 2008/7/1/pubmed PY - 2009/3/20/medline PY - 2008/7/1/entrez SP - 205 EP - 14 JF - Journal of psychiatric research JO - J Psychiatr Res VL - 43 IS - 3 N2 - OBJECTIVE: Patients (30-50%) with non-psychotic major depression will not respond despite an adequate trial of antidepressant medication. This study evaluated risperidone as an augmenting agent for patients who failed or only partially responded to an adequate trial of an antidepressant medication. METHOD: Ninety-seven patients with unipolar non-psychotic major depression who were not responsive to antidepressant monotherapy were randomized to risperidone (0.5-3mg/day) or placebo augmentation in a four-week, double-blind, placebo controlled treatment trial. The primary outcome measure was remission defined by a score of < or =10 on the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcomes measures were the Hamilton Rating Scale for Depression, the Clinician Global Impression of Severity scale and the overall satisfaction item of the Quality of Life and Enjoyment Questionnaire. RESULTS: Subjects in both treatment groups improved significantly over time. The odds of remitting were significantly better for patients in the risperidone vs. placebo arm (OR=3.33, p=.011). At the end of 4 weeks of treatment 52% of the risperidone augmentation group remitted (MADRS< or =10) compared to 24% of the placebo augmentation group (CMH(1)=6.48, p=.011), but the two groups were converging. Patients in the risperidone group also reported significantly more improvement in quality-of-life than patients in the placebo group. There were no between-group differences in the number of adverse events reported, however, weight gain was significantly higher in the group receiving risperidone. CONCLUSION: Augmentation of an antidepressant with risperidone for patients with difficult-to-treat depression leads to more rapid response and a higher remission rate and better quality-of-life. SN - 0022-3956 UR - https://www.unboundmedicine.com/medline/citation/18586273/A_randomized_placebo_controlled_trial_of_risperidone_augmentation_for_patients_with_difficult_to_treat_unipolar_non_psychotic_major_depression_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3956(08)00116-7 DB - PRIME DP - Unbound Medicine ER -