Ziprasidone augmentation for anxious depression.
Previously, we found an anxiolytic effect of ziprasidone augmentation to escitalopram (compared with placebo augmentation) in patients with depression in an 8-week, randomized, double-blind, parallel-group, placebo-controlled trial. Here, we carried out a post-hoc analysis, comparing changes in the Hamilton Depression and Anxiety Rating Scales between patients with anxious depression versus nonanxious depression, using a moderator analysis. Hamilton Depression Rating Scales total change scores from baseline and endpoint were not significantly different (interaction term P=0.91) in patients with anxious depression on ziprasidone augmentation (n=19; -9.1±4.9) or placebo (n=19; -6.1±8.9) versus patients without anxious depression on ziprasidone (n=52; -5.5±6.7) or placebo (n=49; -2.3±4.5). There was a trend toward statistical significance (interaction term P=0.1) in favor of patients without anxious depression for a difference in Hamilton Anxiety Rating Scale total change scores from baseline to endpoint [patients with anxious depression on ziprasidone augmentation (n=19; -2.7±5.3) or placebo (n=19; -3.3±5.8) versus patients without anxious depression on ziprasidone (n=51; -3.9±6.6) or placebo (n=44; -0.9±4.7)]. Ziprasidone augmentation was equally efficacious in treating depression in patients with versus without anxious depression. However, the observed anxiolytic effect for patients with higher anxiety was not clinically significant.
aDepartment of Psychiatry, Massachusetts General Hospital bHarvard Medical School, Boston, Massachusetts cDepartment of Psychiatry, Office of Psychiatric Clinical Research, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Dawn F
DF
Ionescu
Richard C
RC
Shelton
Lee
L
Baer
Kathryn H
KH
Meade
Michaela B
MB
Swee
Maurizio
M
Fava
George I
GI
Papakostas
D000293:Adolescent; D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001007:Anxiety / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D015283:Citalopram / Q000008:administration & dosage*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage*; D013844:Thiazoles / Q000008:administration & dosage*; D055815:Young Adult
D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; D015283:Citalopram; C092292:ziprasidone