K S Bingham1, B S Meyers2, B H Mulsant1,3, A J Rothschild4, E M Whyte5, S Banerjee6, A S Artis6, G S Alexopoulos2, A J Flint1,7. 1. Department of Psychiatry, University of Toronto, Toronto, ON, Canada. 2. Department of Psychiatry, Weill Medical College of Cornell University and New York Presbyterian Hospital, Westchester Division, White Plains, NY, USA. 3. Centre for Addiction and Mental Health, Toronto, ON, Canada. 4. UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA. 5. Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 6. Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA. 7. Centre for Mental Health, University Health Network, Toronto, ON, Canada.
Abstract
OBJECTIVE: We conducted a 12-week double-blind study of stabilization pharmacotherapy in patients with remitted psychotic depression (PD). METHODS:Seventy-one persons aged 18 years or older who had achieved remission of PD when randomized to eitherolanzapine plus sertraline or olanzapine plus placebo were continued on the double-blind treatment associated with remission. Symptoms of depression and psychosis, and weight, were measured once every 4 weeks. Cholesterol, triglycerides, and glucose were measured at stabilization phase baseline and Week 12/termination. RESULTS: The effect of treatment did not significantly change with time for depression, weight, or metabolic measures in the stabilization phase. Eight of the 71 participants (11.3%; 95% CI: 5.8, 20.7) experienced a relapse of major depression, psychosis, or both. Treatment groups did not differ in the frequency of relapse. In the entire study group, the adjusted estimate for change in weight was an increase of 1.66 kg (95% CI: 0.83, 2.48) and the adjusted estimate for change in total cholesterol was a decrease of 14.8 mg/dL (95% CI: 3.5, 26.1) during the 12-week stabilization phase; the remaining metabolic measures did not significantly change. CONCLUSION: Continuation of acute treatment was associated with stability of remission.
RCT Entities:
OBJECTIVE: We conducted a 12-week double-blind study of stabilization pharmacotherapy in patients with remitted psychotic depression (PD). METHODS: Seventy-one persons aged 18 years or older who had achieved remission of PD when randomized to either olanzapine plus sertraline or olanzapine plus placebo were continued on the double-blind treatment associated with remission. Symptoms of depression and psychosis, and weight, were measured once every 4 weeks. Cholesterol, triglycerides, and glucose were measured at stabilization phase baseline and Week 12/termination. RESULTS: The effect of treatment did not significantly change with time for depression, weight, or metabolic measures in the stabilization phase. Eight of the 71 participants (11.3%; 95% CI: 5.8, 20.7) experienced a relapse of major depression, psychosis, or both. Treatment groups did not differ in the frequency of relapse. In the entire study group, the adjusted estimate for change in weight was an increase of 1.66 kg (95% CI: 0.83, 2.48) and the adjusted estimate for change in total cholesterol was a decrease of 14.8 mg/dL (95% CI: 3.5, 26.1) during the 12-week stabilization phase; the remaining metabolic measures did not significantly change. CONCLUSION: Continuation of acute treatment was associated with stability of remission.
Authors: Alastair J Flint; Anthony J Rothschild; Ellen M Whyte; George S Alexopoulos; Benoit H Mulsant; Patricia Marino; Samprit Banerjee; Cristina D Pollari; Yiyuan Wu; Aristotle N Voineskos; Barnett S Meyers Journal: Am J Geriatr Psychiatry Date: 2020-11-15 Impact factor: 7.996