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Lithium augmentation in venlafaxine non-responders: an open study
G Bertschy1, E Ragama-Pardos, A Aït-Ameur
1Clinic of Adult Psychiatry, Department of Psychiatry, Geneva University, 2 ch. du Petit Bel-Air, Chene-Bourg, 1225 Geneva, Switzerland. gilles.bertschy@hcuge.ch
Summary
Adding lithium to venlafaxine treatment can help some patients with major depressive disorder who did not respond to venlafaxine alone. Five out of thirteen patients showed a positive response to the augmentation therapy.
Area of Science:
- Psychiatry and Neuropharmacology
- Treatment-Resistant Depression
Background:
- Major depressive disorder (MDD) often requires augmentation strategies for patients unresponsive to standard monotherapy.
- Venlafaxine is a commonly prescribed antidepressant, but a significant portion of patients do not achieve remission.
- Augmentation with lithium is a recognized strategy for treatment-resistant depression (TRD).
Purpose of the Study:
- To evaluate the efficacy and safety of lithium augmentation in patients with MDD refractory to high-dose venlafaxine.
- To assess response rates in a cohort of treatment-resistant depressed patients.
Main Methods:
- An open-label trial was conducted.
- Thirteen patients with MDD, non-responsive to a 4-week treatment of venlafaxine 300 mg daily, were enrolled.
- Eligible patients received an additional 4-week trial of lithium augmentation.
Main Results:
- Five out of thirteen patients (38.5%) achieved a response to lithium augmentation.
- Response included one dramatic and two semi-rapid responses.
- Two patients discontinued lithium due to a possible moderate serotonin syndrome.
Conclusions:
- Lithium augmentation may be an effective strategy for a subset of patients with major depressive disorder non-responsive to venlafaxine 300 mg.
- Careful monitoring for side effects, such as serotonin syndrome, is warranted during lithium augmentation.