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Re: Opinions: Risperdal v. Zyprexa as AD augmentor??

Posted by juanantoniod on July 11, 2003, at 15:35:50

In reply to Opinions: Risperdal v. Zyprexa as AD augmentor??, posted by Jack Smith on July 10, 2003, at 17:41:26

I hope these are helpful. They are from the recent American Psychiatrists Association meeting.

Antipsychotic Augmentation in Treatment-Resistant Depression[4]

There has been recent interest in the use of atypical antipsychotics as augmenting agents in the treatment of depression. This study reported on the preliminary results from the large, international, multicenter ARISe-RD trial. Patients included in this trial had all failed previous treatments with antidepressants, as well as a prospective 4- to 6-week course of citalopram. Patients not responding to citalopram received open-label risperidone augmentation (0.25-2 mg/day). This study presented data from 41 enrolled subjects, of whom 80% did not respond to the citalopram. Subjects receiving risperidone augmentation (n= 33) had significant improvement in HRSD and Montgomery-Asberg Depression Rating Scale (MADRS) total scores with mean percentage reductions of 49.9% on the HRSD and 47% on the MADRS (P < .001). Significant improvement was noted by day 4 of augmentation. The authors concluded that the preliminary data suggest that augmentation with low-dose risperidone provides a rapid, robust improvement of depressive symptoms in treatment-resistant patients without evidence of movement disorders liability.

Major Depression and Long-term Olanzapine/Fluoxetine Use[10]

This is the final data presentation from a long-term study investigating the use of an olanzapine/fluoxetine combination in the treatment of major depressive disorder (MDD) in a group of patients with or without treatment-resistant depression (TRD). The open-label study followed 560 patients treated for 76 weeks. The primary outcome measure was the MADRS. MADRS mean total scores decreased 6 points from baseline (31.6; n = 552) at a half week of treatment, 11 points at 1 week, 18 points at 8 weeks, and 22 points at 76 weeks. Response and remission rates for the total sample were high (62% and 56%, respectively), and the relapse rate was low (15%). Response, remission, and relapse rates for TRD patients (n = 145) were 53%, 44%, and 25%, respectively. Adverse events included somnolence, weight gain, dry mouth, increased appetite, and headache. At end point, there were no clinically meaningful changes in vital signs, laboratory values, or electrocardiography, and no significant increases on measures of extrapyramidal symptoms. Overall this study suggests that olanzapine/fluoxetine can product rapid, robust, and long-term improvements in depressive symptoms in patients with MDD. The combination was also effective in TRD patients, and the side-effect profile of the combination appears to be similar to that of its component monotherapies.

They indicate that both are helpful. I'm on Resperidol because my pdoc won't give me Zyprexa because of the blood sugar complications (I already have Type 1 diabetes), and the weight gain.


> Just an idea I am toying with. Really unsure about doing it but what are people's experiences with either med simply as an AD augmentor.
> I am having a partial response to effexor (been at 300 for about a month after about two months moving up). Looking into a whole bunch of options. I have depression with a strong anxiety component.
> Thanks to anyone,




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