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Aripiprazole augmentation in treatment-resistant depression
James G Barbee1, Erich J Conrad, Nowal J Jamhour
1Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA. jbarbe@lsuhsc.edu
Summary
Aripiprazole augmentation improved treatment-resistant depression in patients who previously failed other atypical neuroleptics. Nearly half showed improvement, though long-term response rates were lower, indicating potential efficacy in highly refractory cases.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Atypical neuroleptics show promise for refractory mood disorders.
- Limited data exists on atypical neuroleptic efficacy after prior treatment failure within the same class.
Purpose of the Study:
- To investigate aripiprazole's efficacy in augmenting antidepressant treatment for treatment-resistant depression.
- To assess aripiprazole in patients who previously failed another atypical neuroleptic.
Main Methods:
- Retrospective chart review of 30 treatment-resistant unipolar depression patients.
- Patients had failed multiple antidepressants and at least one other atypical neuroleptic.
- Assessed using Global Assessment of Functioning (GAF) and Clinical Global Impressions-Improvement scores.
Main Results:
- 46.7% of patients showed significant improvement (much or very much improved).
- Improvement correlated inversely with Thase-Rush staging of treatment resistance.
- Long-term net response rate was 26.7% after accounting for relapses.
Conclusions:
- Aripiprazole may be an effective augmentation strategy for highly treatment-resistant depression.
- This includes patients with a history of failed atypical neuroleptic treatment.