title: Faster response in depressive patients treated with fluoxetine alone than in combination with buspirone.
abstract: BACKGROUND
  The aim of this study was to compare the antidepressant efficacy of standard dose, dose optimization of antidepressant drug and buspirone augmentation strategies.
  
  
  METHODS
  120 outpatients with a DSM-IV diagnosis of unipolar depression were randomised to 12-weeks of open label treatment with fluoxetine 20 (flx20) or 40 mg (flx40) daily or fluoxetine 20 mg plus buspirone 20 mg daily (flx20-plus-buspirone). The severity of depression was assessed by Hamilton Depression Rating Scale (HDRS). Response was defined as a 50% or greater reduction of the baseline HDRS total score. A response, which began at any time of the study and was maintained until the last visit, was defined as a sustained response.
  
  
  RESULTS
  The proportion of responders was not significantly different among the treatment groups at the endpoint. Survival analysis showed, however, a significant faster response in the patients treated with flx20 or flx40 alone than flx20-plus-buspirone. The mean times to onset of a sustained response were 33, 24 and 40 days, respectively.
  
  
  CONCLUSIONS
  The lack of treatment-resistant group is a methodological limitation of this study.
  
  
  CONCLUSIONS
  Adding buspirone to fluoxetine in the treatment of major depressive disorder may delay the time to onset of antidepressant efficacy. In order to accelerate and maximise the clinical response in depressive patients, clinician should prefer to optimize the fluoxetine dose instead of in combination with buspirone.
authors.affiliation: Psychiatry Department, Kocaeli University Medical School, Derince, Izmit-Kocaeli 41900, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Onder
authors.forename: Umit
authors.initials: U
authors.lastname: Tural
mesh_terms: D000284:Administration, Oral; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use*; D002065:Buspirone / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011569:Psychiatric Status Rating Scales; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D017366:Serotonin Receptor Agonists; D005473:Fluoxetine; D002065:Buspirone