Premium
Augmentation with olanzapine in TCA‐refractory depression with melancholic features: a consecutive case series
Author(s) -
Takahashi Hitoshi,
Kamata Mitsuhiro,
Yoshida Keizo,
Higuchi Hisashi,
Ishigooka Jun
Publication year - 2008
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.914
Subject(s) - olanzapine , amitriptyline , melancholia , refractory (planetary science) , rating scale , depression (economics) , medicine , psychology , antidepressant , tricyclic antidepressant , clinical trial , psychiatry , schizophrenia (object oriented programming) , dexamethasone , developmental psychology , physics , astrobiology , hippocampus , economics , macroeconomics
Using an 8‐week, open label study design, we report the effect of augmentation strategy with olanzapine in hospitalized depressive patients with melancholic features who had insufficient response to a tricyclic antidepressant (TCA), amitriptyline. Subjects were hospitalized patients meeting the criteria of DSM‐IV major depressive disorder with melancholic features who had been suffering from residual symptoms after treatment of amitriptyline. After study entry, olanzapine was added to amitriptyline and the dose was adjusted according to patients' clinical condition. Data were analyzed using an intent‐to‐treat methodology, with last observation carried forward. Paired t ‐test was adopted to assess the data from baseline to endpoint. Of 26 patients who enrolled in this study, 23 patients completed the trial and 3 patients dropped out. The mean dose of olanzapine was 6.5 (SD = 2.4) mg/day. The mean score of Montgomery–Asberg Depression Rating Scale (MADRS) was significantly decreased from 33.6 (SD = 3.5) to 20.8 (SD = 9.1) during this study (37.9% from baseline) ( p < 0.001). Ten patients (38.5%) were considered as responders (50% or greater reduction in MADRS scores from baseline). These results suggest that augmentation with olanzapine in TCAs‐resistant melancholia may be effective and well tolerated. We cannot draw any conclusion with certainty from the open‐label, uncontrolled clinical trial. Double blind, controlled trial is needed to confirm this preliminary finding. Copyright © 2008 John Wiley & Sons, Ltd.