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An open pilot study combining risperidone and a selective serotonin reuptake inhibitor as initial antidepressant
Shigehiro Hirose1, Charles R Ashby
1Center of Psychiatry and Neurology, Fukui Prefectural Hospital, Fukui, Japan. shigehiro@p2422.nsk.ne.jp
The Journal of Clinical Psychiatry
|August 29, 2002
Summary
Combining selective serotonin reuptake inhibitors (SSRIs) with atypical antipsychotics like risperidone may improve major depression treatment. Early combination therapy showed enhanced therapeutic response rates in a 6-week study.
Area of Science:
- Psychiatry and Clinical Psychology
- Pharmacology and Therapeutics
Background:
- Major depressive disorder (MDD) often requires augmentation strategies when selective serotonin reuptuptake inhibitors (SSRIs) alone are insufficient.
- Atypical antipsychotics, such as risperidone, are sometimes added to SSRIs for treatment-resistant depression.
Purpose of the Study:
- To investigate the efficacy of initiating treatment for major depression with a combination of an SSRI (fluvoxamine) and an atypical antipsychotic (risperidone).
Main Methods:
- Thirty-six patients with major depressive disorder received fluvoxamine and risperidone concurrently from the start of treatment.
- Dosages were adjusted, and Hamilton Rating Scale for Depression (HAM-D) scores were assessed weekly for six weeks.
- Remission was defined as >=75% HAM-D score reduction; response was defined as 50%-74% reduction.
Main Results:
- Of 30 completers, 76% achieved remission and 17% achieved response.
- Among the 6 who dropped out, 3 showed remission and 1 showed response.
- Adverse effects were mild, with no reported extrapyramidal symptoms, nausea, or vomiting.
Conclusions:
- Initiating antidepressant therapy with a combination of risperidone and fluvoxamine enhances the therapeutic response rate in patients with major depression.
- This combination therapy appears to be well-tolerated, with a low incidence of adverse effects.