Olanzapine augmentation in the treatment of melancholia: the trajectory of improvement in rapid responders.
It has been suggested that the atypical antipsychotic drugs may induce a rapid improvement in individuals with melancholic depression. This might reflect a specific or non-specific effect on mood and other parameters. To examine this issue, ten consecutive patients, for whom olanzapine augmentation was judged a clinically appropriate strategy, were asked to complete daily ratings of depression severity and component features for 1 week. Of the six rapid responders, there was a 52% group improvement in the first day and 89% improvement at 1 week. Item analyses suggested the most rapid impact was evident for insomnia, compared to a slower and linear improvement in depressed mood. Such findings may assist in an understanding of the mechanisms underlying augmentation with atypical neuroleptic drugs.
Parker
G
G
Mood Disorders Unit and School of Psychiatry, Prince of Wales Hospital, Randwick, Australia. g.parker@unsw.edu.au
D000328:Adult; D000339:Affect / Q000187:drug effects; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy; D001569:Benzodiazepines; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010349:Patient Compliance; D010890:Pirenzepine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D012008:Recurrence; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine