The impact of ziprasidone in combination with sertraline on visually-evoked event-related potentials in depressed patients with psychotic features.
BACKGROUND
The use of atypical antipsychotics in major depression complicated by psychotic features has not been extensively investigated. Event-related potentials (ERP) have been reported to be impaired in depressed patients, probably due to serotonergic hypofunction. The objective of this study was to examine the effects of a combination therapy with ziprasidone and sertraline on ERP in major depression with psychotic features.


METHODS
19 patients with major depression with psychotic features were treated with ziprasidone and sertraline. Before and after four weeks of treatment, visually-evoked ERP (P3 -- oddball paradigm) were investigated.


RESULTS
While a significant clinical improvement assessed with the Brief Psychiatric Rating Scale and Hamilton Depression Rating Scale was noted, no significant changes in weight, basal prolactin values and scores on the Extrapyramidal Symptoms Scale were observed. A significant prolongation (p = 0.041) of the QTc-interval between baseline and endpoint showed no clinical symptoms. Combination treatment with ziprasidone and sertraline over 4 weeks was associated with a significant decrease (p = 0.033) of P3 latencies from baseline to week 4. After a four week treatment, significantly (p = 0.008) fewer patients showed pathologically P3 latencies (>450 ms) than at baseline.


CONCLUSIONS
Our data, showing that ziprasidone in combination with sertraline lead to a decrease of prolonged P3 latencies, are in line with previous studies showing a decrease of prolonged P3 latencies by antidepressant treatment.
Department of Psychiatry and Psychotherapy, RWTH Aachen University, Pauwelsstrasse 30, D-52074 Aachen, Germany. omoeller@ukaachen.de
O
O
Moeller
S
S
Evers
J
J
Deckert
B T
BT
Baune
U
U
Dannlowski
D H
DH
Nguyen
V
V
Arolt
G
G
Hetzel
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000188:drug therapy* / Q000523:psychology*; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003627:Data Interpretation, Statistical; D004359:Drug Therapy, Combination; D005074:Evoked Potentials, Visual / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D020280:Sertraline / Q000009:adverse effects / Q000627:therapeutic use*; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D010879:Piperazines; D011388:Prolactin; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline; D013844:Thiazoles; C092292:ziprasidone