title: Antidepressant monotherapy compared with combinations of antidepressants in the treatment of resistant depressive patients: a randomized, open-label study.
abstract: OBJECTIVE
  This randomized, 6-week, open-label study compared efficacy of CAD and antidepressant monotherapies (ADM) that had been chosen according to clinical judgment of the attending psychiatrist.
  
  
  METHODS
  A total of 60 inpatients (intent-to-treat analysis) with depressive disorder (≥ 1 unsuccessful antidepressant treatment) were randomly assigned to the interventions. The responders who completed the acute phase of study, were evaluated for relapse within 2 months of follow-up treatment. The primary outcome measure was change in the Montgomery-Åsberg Depression Rating Scale (MADRS) and response was defined as a ≥ 50% reduction of MADRS score.
  
  
  RESULTS
  Mean changes in total MADRS score from baseline to week 6 for patients in both treatment modalities were not different (ADM = 13.2 ± 8.6 points; CAD = 14.5 ± 9.5 points; P = 0.58). The analysis of covariance performed for significantly higher value of imipramine equivalent dose in CAD group showed only a non-significant between-group difference for total MADRS change (P = 0.17). There were also no differences between groups in response rate (ADM = 48%; CAD = 58%) and number of drop-outs in acute treatment as well as proportion of responders' relapses in the follow-up.
  
  
  CONCLUSIONS
  Both treatment modalities produced clinically relevant reduction of depressive symptomatology in acute treatment of patients with resistant depression and their effect was comparable.
authors.affiliation: Prague Psychiatric Center, Prague, Czech Republic. bares@pcp.lf3.cuni.cz
authors.forename: Martin
authors.initials: M
authors.lastname: Bares
authors.forename: Tomas
authors.initials: T
authors.lastname: Novak
authors.forename: Miloslav
authors.initials: M
authors.lastname: Kopecek
authors.forename: Pavla
authors.initials: P
authors.lastname: Stopkova
authors.forename: Jan
authors.initials: J
authors.lastname: Cermak
authors.forename: Jiri
authors.initials: J
authors.lastname: Kozeny
authors.forename: Cyril
authors.initials: C
authors.lastname: Höschl
mesh_terms: D000928:Antidepressive Agents / Q000008:administration & dosage*; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents