title: An open study of aripiprazole and escitalopram for psychotic major depressive disorder.
abstract: OBJECTIVE
  This 7-week trial assessed the efficacy and tolerability of aripiprazole combined with escitalopram in the acute treatment of major depressive disorder, with psychotic features (MD-Psy).
  
  
  METHODS
  Sixteen male and female patients with a Diagnostic Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of MD-Psy were recruited for this study from September 13, 2004 to August 9, 2006. Escitalopram and aripiprazole were flexibly dosed for 7 weeks, with maximum dosages of 20 and 30 mg/d, respectively. The 17-item Hamilton Rating Scale for Depression (HAM-D-17) and Structured Clinical Interview for DSM-IV psychosis module were used to measure depression and psychosis responses. The Barnes Akathisia Scale and the Simpson Angus Scale were used to assess for akathisia and extrapyramidal symptoms.
  
  
  RESULTS
  Thirteen of the 16 subjects completed the study. The MD-Psy response rate (50% or greater drop in HAM-D-17 and no psychosis) (intent-to-treat, last observation carried forward) was 62.5%, and the MD-Psy remission rate (HAM-D-17, <8, and no psychosis) (intent-to-treat, last observation carried forward) was 50.0%. Ten of the 16 subjects developed akathisia; however, 9 of the 10 subjects had resolution or partial resolution of akathisia with dose adjustment or treatment with propranolol.
  
  
  CONCLUSIONS
  The combination of escitalopram and aripiprazole seems to be an effective and safe treatment for MD-Psy.
authors.affiliation: Inpatient Psychiatric Services, Harvard Medical School, Massachusetts General Hospital Boston, MA 02114, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Matthews
authors.forename: Caleb
authors.initials: C
authors.lastname: Siefert
authors.forename: Christina
authors.initials: C
authors.lastname: Dording
authors.forename: John W
authors.initials: JW
authors.lastname: Denninger
authors.forename: Lawrence
authors.initials: L
authors.lastname: Park
authors.forename: Adrienne O
authors.initials: AO
authors.lastname: van Nieuwenhuizen
authors.forename: Katherine
authors.initials: K
authors.lastname: Sklarsky
authors.forename: Sarah
authors.initials: S
authors.lastname: Hilliker
authors.forename: Caitlin
authors.initials: C
authors.lastname: Homberger
authors.forename: Kathryn
authors.initials: K
authors.lastname: Rooney
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000068180:Aripiprazole; D015283:Citalopram / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011618:Psychotic Disorders / Q000188:drug therapy*; D015363:Quinolones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D000068180:Aripiprazole; D015283:Citalopram; D010879:Piperazines; D015363:Quinolones; D017367:Selective Serotonin Reuptake Inhibitors