TY - JOUR
T1 - What to expect from a third step in treatment resistant depression
T2 - A prospective open study on escitalopram
AU - Souery, Daniel
AU - Calati, Raffaella
AU - Papageorgiou, Konstantinos
AU - Juven-Wetzler, Alzbeta
AU - Gailledreau, Joël
AU - Modavi, David
AU - Sentissi, Othman
AU - Pitchot, William
AU - Papadimitriou, George N.
AU - Dikeos, Dimitris
AU - Montgomery, Stuart
AU - Kasper, Siegfried
AU - Zohar, Joseph
AU - Serretti, Alessandro
AU - Mendlewicz, Julien
N1 - Publisher Copyright:
© 2014 © 2014 Informa Healthcare.
PY - 2015/10/3
Y1 - 2015/10/3
N2 - Objectives. Only few studies investigated treatment strategies for treatment resistant depression (TRD). The objective of this multicentre study was to evaluate TRD patients who did not respond to at least two antidepressants. Methods. A total of 417 patients, who failed to respond to a previous retrospectively assessed antidepressant (AD1), were firstly included in a 6-week venlafaxine treatment (AD2); secondly, those who failed to respond were treated for further 6 weeks with escitalopram (AD3). Results. Out of 417 patients who had failed to respond to previous treatment (AD1), 334 completed treatment with venlafaxine to prospectively define TRD. In the intent to treat (ITT) population in the first phase of the trial (AD2), responders to venlafaxine were 151 (36.21%) out of which remitters were 83 (19.90%). After phase one, 170 non-responders, defined as TRD, were included in the second phase and 157 completed the course. Of the 170 ITT entering the second phase (AD3), responders to escitalopram were 71 (41.76%) out of which remitters were 39 (22.94%). After the third treatment, patients showed a dropout rate of 7.65% and a rate of presence of at least one serious adverse event of 19.18%. Conclusions. Relevant rates of response and remission may be observed after a third line treatment in patients resistant to two previous treatments. A relevant limitation of this study was represented by the design: naturalistic, non-randomized, open-label, without a control sample and with unblinded raters.
AB - Objectives. Only few studies investigated treatment strategies for treatment resistant depression (TRD). The objective of this multicentre study was to evaluate TRD patients who did not respond to at least two antidepressants. Methods. A total of 417 patients, who failed to respond to a previous retrospectively assessed antidepressant (AD1), were firstly included in a 6-week venlafaxine treatment (AD2); secondly, those who failed to respond were treated for further 6 weeks with escitalopram (AD3). Results. Out of 417 patients who had failed to respond to previous treatment (AD1), 334 completed treatment with venlafaxine to prospectively define TRD. In the intent to treat (ITT) population in the first phase of the trial (AD2), responders to venlafaxine were 151 (36.21%) out of which remitters were 83 (19.90%). After phase one, 170 non-responders, defined as TRD, were included in the second phase and 157 completed the course. Of the 170 ITT entering the second phase (AD3), responders to escitalopram were 71 (41.76%) out of which remitters were 39 (22.94%). After the third treatment, patients showed a dropout rate of 7.65% and a rate of presence of at least one serious adverse event of 19.18%. Conclusions. Relevant rates of response and remission may be observed after a third line treatment in patients resistant to two previous treatments. A relevant limitation of this study was represented by the design: naturalistic, non-randomized, open-label, without a control sample and with unblinded raters.
KW - antidepressants
KW - escitalopram
KW - major depressive disorder
KW - pharmacotherapy
KW - resistant depression
UR - http://www.scopus.com/inward/record.url?scp=84947037016&partnerID=8YFLogxK
U2 - 10.3109/15622975.2014.987814
DO - 10.3109/15622975.2014.987814
M3 - Article
C2 - 25535987
AN - SCOPUS:84947037016
SN - 1562-2975
VL - 16
SP - 472
EP - 482
JO - World Journal of Biological Psychiatry
JF - World Journal of Biological Psychiatry
IS - 7
ER -