Jonathan H Hsu1, Benoit H Mulsant1, Eric J Lenze2, Jordan F Karp3, Helen Lavretsky4, Steven P Roose5, Charles F Reynolds6, Daniel M Blumberger7. 1. Campbell Family Research Institute, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 2. Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine. 3. University of Pittsburgh School of Medicine, Pittsburgh, PA; VAPHS Geriatric Research, Education, and Clinical Center, Pittsburgh, PA. 4. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA. 5. Columbia University and the New York State Psychiatric Institute, New York, NY. 6. University of Pittsburgh School of Medicine, Pittsburgh, PA. 7. Campbell Family Research Institute, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. Electronic address: daniel.blumberger@camh.ca.
Abstract
OBJECTIVE: Treatment history can inform clinical decisions about subsequent treatment choices. The authors examined the impact of prior antidepressant treatment on treatment outcomes with venlafaxine only and then with augmentation with aripiprazole or placebo in depressed older adults. METHODS: The authors analyzed outcome data from a randomized, placebo-controlled clinical trial of aripiprazole augmentation in depressed older adults. The study consisted of an open-label lead-in phase with venlafaxine XR, followed by a placebo-controlled phase of aripiprazole augmentation. Treatment history was assessed with the Antidepressant Treatment History Form. RESULTS: Documented prior treatment failure predicted a reduced remission rate with venlafaxine. However, aripiprazole augmentation was efficacious in those with prior treatment failure (42.6% remission with aripiprazole versus 25.8% with placebo; χ(2) = 3.87 df = 1, p = 0.049). CONCLUSION:Aripiprazole augmentation is an efficacious strategy in older depressed adults who fail to remit with two or more adequate antidepressant trials, including a course of venlafaxine.
RCT Entities:
OBJECTIVE: Treatment history can inform clinical decisions about subsequent treatment choices. The authors examined the impact of prior antidepressant treatment on treatment outcomes with venlafaxine only and then with augmentation with aripiprazole or placebo in depressed older adults. METHODS: The authors analyzed outcome data from a randomized, placebo-controlled clinical trial of aripiprazole augmentation in depressed older adults. The study consisted of an open-label lead-in phase with venlafaxine XR, followed by a placebo-controlled phase of aripiprazole augmentation. Treatment history was assessed with the Antidepressant Treatment History Form. RESULTS: Documented prior treatment failure predicted a reduced remission rate with venlafaxine. However, aripiprazole augmentation was efficacious in those with prior treatment failure (42.6% remission with aripiprazole versus 25.8% with placebo; χ(2) = 3.87 df = 1, p = 0.049). CONCLUSION:Aripiprazole augmentation is an efficacious strategy in older depressed adults who fail to remit with two or more adequate antidepressant trials, including a course of venlafaxine.
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