Augmentation with open-label atomoxetine for partial or nonresponse to antidepressants.
BACKGROUND
Atomoxetine is a selective nor-epinephrine reuptake inhibitor currently approved for the treatment of attention-deficit/hyperactivity disorder. Other compounds that enhance synaptic norepinephrine have shown efficacy as antidepressant monotherapies and as augmentation agents. This case series study examined the role of atomoxetine in antidepressant augmentation.


METHODS
Fifteen adult outpatients with primary DSM-IV Axis I depressive disorders received open-label atomoxetine augmentation following partial response or nonresponse to at least 8 weeks of standard antidepressant pharmacotherapy. Atomoxetine 40 mg/day was added to ongoing medication regimens and titrated according to clinical response. Atomoxetine was systematically offered to patients from July through October 2003.


RESULTS
Eleven patients (73%) completed at least 6 weeks of atomoxetine augmentation. Mean endpoint dose was approximately 80 mg/day. Nine patients (60%) met criteria for positive categorical response. Inventory of Depressive Symptomatology-Self-Report scores decreased significantly from baseline to endpoint, and clinician ratings of social and occupational functioning increased. There were no significant changes in heart rate or blood pressure, and the most common side effect was activation. A modest but significant drop in body mass index was observed (p = .025), and a subset (6/15; 40%) of patients reported improved sexual function.


CONCLUSIONS
More studies are warranted to evaluate the potential utility of atomoxetine for antidepressant augmentation.
Carpenter
Linda L
LL
Mood Disorders Research Program, Butler Hospital, Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI 02906, USA. Linda_Carpenter_MD@Brown.edu
Milosavljevic
Nada
N
Schecter
Jordan M
JM
Tyrka
Audrey R
AR
Price
Lawrence H
LH
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011437:Propylamines / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy / Q000523:psychology; D016896:Treatment Outcome
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride