Hitoshi Sakurai1, Christina Dording2, Albert Yeung2, Simmie Foster2, Felipe Jain2, Trina Chang2, Nhi-Ha Trinh2, Richard Bernard2, Sean Boyden2, Syed Z Iqbal3, Samuel T Wilkinson4, Sanjay J Mathew3, David Mischoulon2, Maurizio Fava2, Cristina Cusin5. 1. Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 6th Floor, Boston, MA, USA; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan. 2. Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 6th Floor, Boston, MA, USA. 3. Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA; Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA. 4. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. 5. Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 6th Floor, Boston, MA, USA. Electronic address: ccusin@mgh.harvard.edu.
Abstract
BACKGROUND: While riluzole has been investigated for the treatment of depression, little is known about its longer-term efficacy and optimal treatment duration in treatment-resistant depression (TRD). The objective of this study is to characterize the longer-term outcome of adjunctive riluzole therapy for TRD in an open-label extension of an 8-week acute treatment trial. METHODS: The data from 66 patients with TRD who received adjunctive riluzole in a 12-week open-label extension phase were analyzed. Response rates (⩾50% reduction in the Mongomery-Asberg Depression Rating Scale [MADRS] score), relapse rates (a MADRS score of ⩾22 in patients who had previously achieved response), and adverse events were examined in patients who had achieved response at the end of the acute phase and those who had not. RESULTS: Among acute phase responders, the maintained response rate was 66.7% (8/12) and the relapse rate was 8.3% (1/12). In acute phase non-responders, the response rate was 24.1% (13/54). The most commonly reported adverse event was fatigue (9.1%). Three cases were considered serious adverse events; vomiting (n = 1), shortness of breath (n = 1), and aborted suicide attempt (n = 1). LIMITATIONS: This longer-term study was open-label and uncontrolled. The sample size was relatively small. CONCLUSIONS: Longer-term adjunctive riluzole appears relatively well tolerated and beneficial for maintaining previous response. Additionally, approximately one fourth of patients who did not respond to 8-week antidepressant treatment might respond if treated with riluzole for 12 weeks. Those findings warrant further investigation because adjunctive riluzole could represent an option for treatment of depression when standard antidepressants have failed.
BACKGROUND: While riluzole has been investigated for the treatment of depression, little is known about its longer-term efficacy and optimal treatment duration in treatment-resistant depression (TRD). The objective of this study is to characterize the longer-term outcome of adjunctive riluzole therapy for TRD in an open-label extension of an 8-week acute treatment trial. METHODS: The data from 66 patients with TRD who received adjunctive riluzole in a 12-week open-label extension phase were analyzed. Response rates (⩾50% reduction in the Mongomery-Asberg Depression Rating Scale [MADRS] score), relapse rates (a MADRS score of ⩾22 in patients who had previously achieved response), and adverse events were examined in patients who had achieved response at the end of the acute phase and those who had not. RESULTS: Among acute phase responders, the maintained response rate was 66.7% (8/12) and the relapse rate was 8.3% (1/12). In acute phase non-responders, the response rate was 24.1% (13/54). The most commonly reported adverse event was fatigue (9.1%). Three cases were considered serious adverse events; vomiting (n = 1), shortness of breath (n = 1), and aborted suicide attempt (n = 1). LIMITATIONS: This longer-term study was open-label and uncontrolled. The sample size was relatively small. CONCLUSIONS: Longer-term adjunctive riluzole appears relatively well tolerated and beneficial for maintaining previous response. Additionally, approximately one fourth of patients who did not respond to 8-week antidepressant treatment might respond if treated with riluzole for 12 weeks. Those findings warrant further investigation because adjunctive riluzole could represent an option for treatment of depression when standard antidepressants have failed.
Authors: Husseini K Manji; Jorge A Quiroz; Jonathan Sporn; Jennifer L Payne; Kirk Denicoff; Neil A Gray; Carlos A Zarate; Dennis S Charney Journal: Biol Psychiatry Date: 2003-04-15 Impact factor: 13.382
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Authors: Carlos A Zarate; Jennifer L Payne; Jorge Quiroz; Jonathan Sporn; Kirk K Denicoff; David Luckenbaugh; Dennis S Charney; Husseini K Manji Journal: Am J Psychiatry Date: 2004-01 Impact factor: 18.112
Authors: Daniel F Levey; Murray B Stein; Frank R Wendt; Gita A Pathak; Hang Zhou; Mihaela Aslan; Rachel Quaden; Kelly M Harrington; Yaira Z Nuñez; Cassie Overstreet; Krishnan Radhakrishnan; Gerard Sanacora; Andrew M McIntosh; Jingchunzi Shi; Suyash S Shringarpure; John Concato; Renato Polimanti; Joel Gelernter Journal: Nat Neurosci Date: 2021-05-27 Impact factor: 28.771