title: Impact of Prior Treatment on Remission of Late-Life Depression with Venlafaxine and Subsequent Aripiprazole or Placebo Augmentation.
abstract: Treatment history can inform clinical decisions about subsequent treatment choices. The authors examined the impact of prior antidepressant treatment on treatment outcomes with venlafaxine only and then with augmentation with aripiprazole or placebo in depressed older adults.
  
  
  
  The authors analyzed outcome data from a randomized, placebo-controlled clinical trial of aripiprazole augmentation in depressed older adults. The study consisted of an open-label lead-in phase with venlafaxine XR, followed by a placebo-controlled phase of aripiprazole augmentation. Treatment history was assessed with the Antidepressant Treatment History Form.
  
  
  
  Documented prior treatment failure predicted a reduced remission rate with venlafaxine. However, aripiprazole augmentation was efficacious in those with prior treatment failure (42.6% remission with aripiprazole versus 25.8% with placebo; χ(2) = 3.87 df = 1, p = 0.049).
  
  
  
  Aripiprazole augmentation is an efficacious strategy in older depressed adults who fail to remit with two or more adequate antidepressant trials, including a course of venlafaxine.
authors.affiliation: Campbell Family Research Institute, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Hsu
authors.affiliation: Campbell Family Research Institute, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Benoit H
authors.initials: BH
authors.lastname: Mulsant
authors.affiliation: Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lenze
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA; VAPHS Geriatric Research, Education, and Clinical Center, Pittsburgh, PA.
authors.forename: Jordan F
authors.initials: JF
authors.lastname: Karp
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA.
authors.forename: Helen
authors.initials: H
authors.lastname: Lavretsky
authors.affiliation: Columbia University and the New York State Psychiatric Institute, New York, NY.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Roose
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
authors.affiliation: Campbell Family Research Institute, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. Electronic address: daniel.blumberger@camh.ca.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Blumberger
mesh_terms: D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000067562:Late Onset Disorders / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride / Q000627:therapeutic use*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D000069470:Venlafaxine Hydrochloride; D000068180:Aripiprazole
keywords: Geriatric depression; antidepressant; aripiprazole; augmentation; randomized controlled trial; treatment resistance; venlafaxine