Article

Augmentation treatment in major depressive disorder: Focus on aripiprazole

University of California San Francisco, 401 Parnussus Avenue, Box 0984-F,San Francisco, California, USA.
Neuropsychiatric Disease and Treatment (Impact Factor: 1.74). 11/2008; 4(5):937-48.
Source: PubMed

ABSTRACT

Major depressive disorder (MDD) is a disabling psychiatric condition for which effective treatment remains an outstanding need. Antidepressants are currently the mainstay of treatment for depression; however, almost two-thirds of patients will fail to achieve remission with initial treatment. As a result, a range of augmentation and combination strategies have been used in order to improve outcomes for patients. Despite the popularity of these approaches, limited data from double-blind, randomized, placebo-controlled studies are available to allow clinicians to determine which are the most effective augmentation options or which patients are most likely to respond to which options. Recently, evidence has shown that adjunctive therapy with atypical antipsychotics has the potential for beneficial antidepressant effects in the absence of psychotic symptoms. In particular, aripiprazole has shown efficacy as an augmentation option with standard antidepressant therapy in two, large, randomized, double-blind studies. Based on these efficacy and safety data, aripiprazole was recently approved by the FDA as adjunctive therapy for MDD. The availability of this new treatment option should allow more patients with MDD to achieve remission and, ultimately, long-term, successful outcomes.

Download full-text

Full-text

Available from: J. Craig Nelson, Mar 27, 2015
  • Source
    • "Depression with melancholic features is also associated with poor outcomes, as well as more acute treatment steps and greater levels of treatment resistance (Rush et al., 2009), whereas patients with MDD with psychotic features are more likely to exhibit relapse than non-psychotic patients (Rothschild, 2003). Depression may also feature as a comorbid condition in patients with substance use disorders (Ostacher, 2007) or with chronic diseases such as diabetes or arthritis (Nelson et al., 2008). In cases such as these, MDD may act synergistically with the comorbid condition, each complicating and worsening the impact of the other. "

    Full-text · Dataset · Oct 2014
  • Source
    • "Depression with melancholic features is also associated with poor outcomes, as well as more acute treatment steps and greater levels of treatment resistance (Rush et al., 2009), whereas patients with MDD with psychotic features are more likely to exhibit relapse than non-psychotic patients (Rothschild, 2003). Depression may also feature as a comorbid condition in patients with substance use disorders (Ostacher, 2007) or with chronic diseases such as diabetes or arthritis (Nelson et al., 2008). In cases such as these, MDD may act synergistically with the comorbid condition, each complicating and worsening the impact of the other. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Treatment-resistant depression (TRD) presents many challenges for both patients and physicians. This review aims to evaluate the current status of the field of TRD and reflects the main findings of a consensus meeting held in September 2009. Literature searches were also conducted using PubMed and EMBASE. Abstracts of the retrieved articles were reviewed independently by the authors for inclusion. Evaluation of the clinical evidence in TRD is complicated by the absence of a validated definition, and there is a need to move away from traditional definitions of remission based on severity of symptoms to one that includes normalisation of functioning. One potential way of improving treatment of TRD is through the use of predictive biomarkers and clinical variables. The advent of new treatments may also help by focusing on neurotransmitters other than serotonin. Strategies such as the switching of antidepressants, use of combination therapy with lithium, atypical antipsychotics and other pharmacological agents can improve outcomes, and techniques such as deep brain stimulation and vagus nerve stimulation have shown promising early results. Despite consistent advances in the pharmacotherapy of mood disorders in the last decade, high rates of TRD are still a challenging aspect of overall management.
    Full-text · Article · Jan 2012 · Journal of Psychopharmacology
  • Source

    Preview · Article · Jul 2009 · Neuropsychiatric Disease and Treatment
Show more