PMID- 11918513
OWN - NLM
STAT- MEDLINE
DCOM- 20020724
LR  - 20221207
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 36
IP  - 4
DP  - 2002 Apr
TI  - Treatment of resistant depression by adding noradrenergic agents to lithium 
      augmentation of SSRIs.
PG  - 634-40
AB  - OBJECTIVE: To examine the efficacy of second-line augmentation with noradrenergic 
      antidepressants (NAs) in depressed patients who partially responded to lithium 
      augmentation of selective serotonin-reuptake inhibitors (SSRIs). CASE SUMMARY: 
      Six patients with major depression or double depression (major depression and 
      dysthymia) who were partially responsive to lithium and SSRI treatment were given 
      either bupropion or desipramine, in an open clinical manner. Improvement was 
      determined and rated by a psychiatrist based on clinical judgment guided by the 
      Clinical Global Impression (CGI) improvement scale and by the Global Assessment 
      of Functioning (GAF) as described in Axis V in the Diagnostic and Statistical 
      Manual of Mental Disorders, Fourth Edition. RESULTS: Among the 6 depressed 
      patients with partial remission (much improved in symptoms and moderate 
      functional improvement: CGI score 2, GAF score 51-60) while taking the SSRI and 
      lithium combination, 2 showed complete remission (very much improved in symptoms 
      and good functioning: CGI 1, GAF 80-100) and 3 achieved near-complete remission 
      (very much improved in symptoms and significant functional recovery: CGI 1, GAF 
      61-80) when given either bupropion or desipramine. One patient did not show any 
      additional clinical or functional improvement. Second-line augmentation with 
      bupropion was better tolerated than desipramine. CONCLUSIONS: This clinical 
      observation suggests that second-line augmentation with NAs may be a viable 
      option to optimize recovery in depressed patients with a partial response to 
      lithium augmentation of SSRIs.
FAU - Ramasubbu, Rajamannar
AU  - Ramasubbu R
AD  - Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. 
      rajamannar.ramasubbu@calgaryhealthregion.ca
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Adrenergic Uptake Inhibitors)
RN  - 0 (Serotonin Uptake Inhibitors)
RN  - 9FN79X2M3F (Lithium)
SB  - IM
MH  - Adrenergic Uptake Inhibitors/*therapeutic use
MH  - Adult
MH  - Depression/*drug therapy/psychology
MH  - Drug Resistance
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Lithium/*administration & dosage/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Psychiatric Status Rating Scales
MH  - Selective Serotonin Reuptake Inhibitors/*therapeutic use
MH  - Treatment Outcome
EDAT- 2002/03/29 10:00
MHDA- 2002/07/26 10:01
CRDT- 2002/03/29 10:00
PHST- 2002/03/29 10:00 [pubmed]
PHST- 2002/07/26 10:01 [medline]
PHST- 2002/03/29 10:00 [entrez]
AID - 10.1345/aph.10408 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2002 Apr;36(4):634-40. doi: 10.1345/aph.10408.