Refractory depression: the addition of lithium to fluoxetine or desipramine.
We carried out an open clinical study with 60 consecutive patients suffering from major depression with melancholia who were resistant to anti-depressants. After at least 6 weeks of desipramine (DMI) or fluoxetine (FX) without improvement, lithium carbonate was added to the anti-depressant. Semistructured clinical interviews using the 7-point Clinical Global Impression Scale and 90-item Symptom Checklist were done at baseline and weeks 1, 6 and 14. Following the addition of lithium, more patients on FX improved within the first week than those on DMI. However, with FX, 6 relapses occurred during the 2 months of follow-up and none with DMI. The unified serotonergic and noradrenergic hypothesis for the antidepressant action could be relevant in drug-refractory depression and should be studied further.
Ontiveros
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A
Research Center, Louis H. Lafontaine Hospital, Montreal, Quebec, Canada.
Fontaine
R
R
Elie
R
R
D000328:Adult; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003891:Desipramine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage*; D006801:Humans; D008094:Lithium / Q000008:administration & dosage*; D016651:Lithium Carbonate; D008297:Male; D008875:Middle Aged; D010556:Personality Tests; D011569:Psychiatric Status Rating Scales
D005473:Fluoxetine; D016651:Lithium Carbonate; D008094:Lithium; D003891:Desipramine