PMID- 15291687
OWN - NLM
STAT- MEDLINE
DCOM- 20040913
LR  - 20190901
IS  - 0160-6689 (Print)
IS  - 0160-6689 (Linking)
VI  - 65
IP  - 7
DP  - 2004 Jul
TI  - The effectiveness of olanzapine, risperidone, quetiapine, and ziprasidone as 
      augmentation agents in treatment-resistant major depressive disorder.
PG  - 975-81
AB  - BACKGROUND: Many questions remain regarding the use of atypical neuroleptics as 
      antidepressant augmentation agents. To date, there have been no reports in the 
      literature regarding the effectiveness of these drugs when trials of one or more 
      of them have failed previously as antidepressant augmentation. METHOD: This 
      retrospective chart review was conducted to determine the effectiveness of 
      olanzapine, risperidone, quetiapine, and ziprasidone when given in a 
      fee-for-service setting as anti-depressant augmentation agents to patients with 
      treatment-resistant, nonpsychotic major depressive disorder (DSM-IV). Prospective 
      (Global Assessment of Functioning [GAF]) along with retrospective (Clinical 
      Global Impressions-Improvement [CGI-I] and -Severity of Illness scales) ratings 
      were completed for each patient. Analyses were conducted in an attempt to 
      identify factors that appeared to correlate with response, including order of 
      administration and Thase-Rush staging of treatment resistance. RESULTS: In this 
      study of 76 medication trials in 49 patients, the overall response rate based on 
      the CGI-I ratings was 65% (32/49). Individual rates of response were 57% (21/37) 
      for olanzapine, 50% (7/14) for risperidone, 33% (6/18) for quetiapine, and 10% 
      (1/10) for ziprasidone. None of the differences between neuroleptics in rates of 
      response were significant. The difference between baseline and final GAF scores 
      was statistically significant only in the olanzapine (p <.001) and risperidone (p 
      =.047) groups. Rates of discontinuation did not vary significantly between 
      agents, though trends were present. Crossover trials from one atypical 
      neuroleptic to another in the event of nonresponse appeared to be effective. 
      CONCLUSIONS: Although limited by its design, this study suggests atypical 
      neuroleptic augmentation of antidepressants may be a viable option in 
      treatment-resistant major depressive disorder.
FAU - Barbee, James G
AU  - Barbee JG
AD  - Department of Psychiatry, Louisiana State University Health Sciences Center, New 
      Orleans 70112, USA. jbarbe@lsuhsc.edu
FAU - Conrad, Erich J
AU  - Conrad EJ
FAU - Jamhour, Nowal J
AU  - Jamhour NJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Psychiatry
JT  - The Journal of clinical psychiatry
JID - 7801243
RN  - 0 (Antidepressive Agents)
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Dibenzothiazepines)
RN  - 0 (Piperazines)
RN  - 0 (Thiazoles)
RN  - 12794-10-4 (Benzodiazepines)
RN  - 2S3PL1B6UJ (Quetiapine Fumarate)
RN  - 6UKA5VEJ6X (ziprasidone)
RN  - L6UH7ZF8HC (Risperidone)
RN  - N7U69T4SZR (Olanzapine)
SB  - IM
MH  - Antidepressive Agents/adverse effects/*therapeutic use
MH  - Antipsychotic Agents/adverse effects/*therapeutic use
MH  - Benzodiazepines/adverse effects/therapeutic use
MH  - Depressive Disorder/diagnosis/*drug therapy/psychology
MH  - Dibenzothiazepines/adverse effects/therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Male
MH  - Medical Records
MH  - Olanzapine
MH  - Piperazines/adverse effects/therapeutic use
MH  - Psychiatric Status Rating Scales
MH  - Quetiapine Fumarate
MH  - Research Design
MH  - Retrospective Studies
MH  - Risperidone/adverse effects/therapeutic use
MH  - Thiazoles/adverse effects/therapeutic use
MH  - Treatment Outcome
EDAT- 2004/08/05 05:00
MHDA- 2004/09/14 05:00
CRDT- 2004/08/05 05:00
PHST- 2004/08/05 05:00 [pubmed]
PHST- 2004/09/14 05:00 [medline]
PHST- 2004/08/05 05:00 [entrez]
AID - 10.4088/jcp.v65n0714 [doi]
PST - ppublish
SO  - J Clin Psychiatry. 2004 Jul;65(7):975-81. doi: 10.4088/jcp.v65n0714.