title: Adjunctive pregabalin in partial responders with major depressive disorder and residual anxiety.
abstract: BACKGROUND
  Anxiety symptoms in depression result often in treatment resistance, residual symptoms, and persistent functional impairment.
  
  
  OBJECTIVE
  To assess the effectiveness and safety of adjunctive pregabalin to antidepressants for residual anxiety in patients with major depressive disorder (MDD).
  
  
  METHODS
  A retrospective chart review was conducted to identify partial responders among patients with MDD with residual anxiety. Twenty such patients (age, 58.4 ± 11.2 years; 15 women; baseline Hamilton Depression Rating Scale [HDRS], 17.1 ± 3.5) who received adjunctive pregabalin for residual anxiety were included. Antidepressants augmented were the selective serotonin reuptake inhibitors (n = 12), mirtazapine (n = 2), and selective serotonin-norepinephrine reuptake inhibitors (n = 6).
  
  
  RESULTS
  Twenty patients received at least 4 weeks of pregabalin treatment after 8 weeks of antidepressant therapy. At week 1 (9 weeks after initiating treatment), pregabalin was prescribed at a mean ± SD dose of 71.2 ± 31.7 mg, and the mean maximum pregabalin dose prescribed was 156.2 ± 76.5 mg (range, 75-300 mg). At week 8, there were 13 responders (13/20 [65%]), and 7 of these 13 patients achieved remission (HDRS17 < 8). There were significant decreases in HDRS scores (13.5 ± 3.1 vs 9.1 ± 2.9, P < 0.000), and HDRS anxiety/somatization subscale scores (6.3 ± 2 to 3.6 ± 1.7, P < 0.000). Adverse effects included somnolence (n = 7), weight gain (n = 3), dizziness (n = 4), dry mouth (n = 6), edema (n = 3), blurred vision (n = 3), difficulty with concentration/attention (n = 8), headache (n = 6), and diarrhea (n = 5).
  
  
  CONCLUSIONS
  The results suggest a possible augmentation role for pregabalin when used in conjunction with conventional antidepressants for residual anxiety in MDD.
authors.affiliation: Department of Clinical Medicine, Sapienza-University of Rome, Rome, Italy. vitalimario@yahoo.it
authors.forename: Mario
authors.initials: M
authors.lastname: Vitali
authors.forename: Enrico
authors.initials: E
authors.lastname: Tedeschini
authors.forename: Martino
authors.initials: M
authors.lastname: Mistretta
authors.forename: Kiki
authors.initials: K
authors.lastname: Fehling
authors.forename: Franca
authors.initials: F
authors.lastname: Aceti
authors.forename: Mauro
authors.initials: M
authors.lastname: Ceccanti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
mesh_terms: D018663:Adrenergic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069583:Pregabalin; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D018663:Adrenergic Agents; D014151:Anti-Anxiety Agents; D000069583:Pregabalin; D017367:Selective Serotonin Reuptake Inhibitors; D005680:gamma-Aminobutyric Acid