An open trial of aripiprazole augmentation for SSRI non-remitters with late-life depression.
OBJECTIVE
To evaluate the efficacy and tolerability of aripiprazole augmentation in elderly depressed patients who did not reach remission after treatment with an SSRI.


METHODS
Outpatients 50 years and older with major depressive disorder not remitting after adequate treatment with an SSRI were eligible for the study. In the 6-week long augmentation phase, antidepressants were continued without change and aripiprazole was titrated if needed to a maximum dose of 15 mg per day. Patients were evaluated at the study endpoint on an intent to treat basis, and the primary outcome measure was remission of depression as measured by Hamilton Rating Scale for Depression (HRSD) <or= 10.


RESULTS
Twenty patients having mean age 63.0 +/- 9.6 years old, HRSD 20.0 +/- 4.2, Beck Depression Inventory (BDI) 21.0 +/- 9.8, Clinical Global Impression-Severity (CGI-S) 3.7 +/- 0.9, and Mini Mental State Examination (MMSE) 29.2 +/- 1.0 entered the study. At the study endpoint, mean HRSD was 7.6 +/- 5.9, BDI 9.1 +/- 9.3, and CGI-S 1.9 +/- 1.1. A 50% remission rate of depression was observed after six weeks of augmentation with aripiprazole. Twenty five percent of subjects did not complete the study. The most frequent side effects observed were dry mouth (25%), agitation/anxiety (20%), and drowsiness (15%).


CONCLUSIONS
In this study 50% of depressed patients not remitting after an adequate trial of an SSRI achieved a final HRSD <or= 10 when given aripiprazole augmentation. Open trials such as this require follow up in a randomized, placebo-controlled trial.
Rutherford
Bret
B
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA. brr8@columbia.edu
Sneed
Joel
J
Miyazaki
Marissa
M
Eisenstadt
Rachel
R
Devanand
Devangere
D
Sackeim
Harold
H
Roose
Steven
S
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000068180:Aripiprazole; D003866:Depressive Disorder / Q000188:drug therapy*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D015363:Quinolones / Q000009:adverse effects / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D000068180:Aripiprazole; D010879:Piperazines; D015363:Quinolones; D017367:Selective Serotonin Reuptake Inhibitors