Faster response in depressive patients treated with fluoxetine alone than in combination with buspirone.
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.
Onder
Emin
E
Psychiatry Department, Kocaeli University Medical School, Derince, Izmit-Kocaeli 41900, Turkey.
Tural
Umit
U
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
D018687:Antidepressive Agents, Second-Generation; D017366:Serotonin Receptor Agonists; D005473:Fluoxetine; D002065:Buspirone