Augmentation strategies for treatment-resistant depression

Current Opinion in Psychiatry

Volumn 22, Issue 1, 2009, Pages 7-12

  Carvalho, André F ^a   Machado, Juliana Raulino ^a   Cavalcante, João L ^b  

^a FEDERAL UNIVERSITY OF CEARÁ   (Brazil)

^b HENRY FORD HEART AND VASCULAR INSTITUTE   (United States)

Author keywords

Antidepressants; Atypical antipsychotics; Augmentation; Lithium; Refractory depression

Indexed keywords

ARIPIPRAZOLE; ATYPICAL ANTIPSYCHOTIC AGENT; BUSPIRONE; CLOZAPINE; DEXAMPHETAMINE; ESTROGEN; LAMOTRIGINE; LIOTHYRONINE; LITHIUM; MECAMYLAMINE; METHYLPHENIDATE; MODAFINIL; OLANZAPINE; PAROXETINE; PINDOLOL; PLACEBO; PROGESTERONE; PSYCHOSTIMULANT AGENT; QUETIAPINE; RISPERIDONE; SEROTONIN UPTAKE INHIBITOR; SERTRALINE; TESTOSTERONE; TRICYCLIC ANTIDEPRESSANT AGENT; VENLAFAXINE; ZIPRASIDONE;

ADJUVANT THERAPY; CLINICAL TRIAL; DEPRESSION; DRUG DOSE INCREASE; DRUG EFFICACY; DRUG HALF LIFE; DRUG MECHANISM; DRUG POTENTIATION; HUMAN; HYPERPROLACTINEMIA; MAJOR DEPRESSION; METABOLIC SYNDROME X; NEUROTRANSMISSION; POSTMENOPAUSE; REMISSION; REVIEW; SCORING SYSTEM; SIDE EFFECT; TARDIVE DYSKINESIA; TREATMENT FAILURE; TREATMENT OUTCOME; TREATMENT PLANNING; TREATMENT RESPONSE; UNSPECIFIED SIDE EFFECT; WEIGHT GAIN;

ANTIDEPRESSIVE AGENTS; ANTIPSYCHOTIC AGENTS; BUSPIRONE; CENTRAL NERVOUS SYSTEM STIMULANTS; DEPRESSIVE DISORDER; DRUG RESISTANCE; DRUG THERAPY, COMBINATION; HUMANS; LITHIUM COMPOUNDS; TREATMENT FAILURE; TRIIODOTHYRONINE;

EID: 57749200986     PISSN: 09517367     EISSN: None     Source Type: Journal    
DOI: 10.1097/YCO.0b013e32831be9ef     Document Type: Review

References (52)

1. Shelton RC. Treatment options for refractory depression. J Clin Psychiatry 1999; 60 (Suppl 4):57-61.
2. Miller IW, Keitner GI, Schatzberg AF, et al. The treatment of chronic depression, part 3: psychosocial functioning before and after treatment with sertraline or imipramine. J Clin Psychiatry 1998; 59:608-619.
3. Thase ME. Evaluating antidepressant therapies: remission as the optimal outcome. J Clin Psychiatry 2003; 64 (Suppl 13):18-25.
4. Thase ME, Entsuah AR, Rudolph RL. Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors. Br J Psychiatry 2001; 178:234-241.
5. Bauer M, Whybrow PC, Angst J, et al. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders, Part 1: acute and continuation treatment of major depressive disorder. World J Biol Psychiatry 2002; 3:5-43.
6. Mischoulon D, Nierenberg AA, Kizilbash L, et al. Strategies for managing depression refractory to selective serotonin reuptake inhibitor treatment: a survey of clinicians. Can J Psychiatry 2000; 45:476-481.
7. Fredman SJ, Fava M, Kienke AS, et al. Partial response, nonresponse, and relapse with selective serotonin reuptake inhibitors in major depression: a survey of current 'next-step' practices. J Clin Psychiatry 2000; 61:403-408.
8. Carvalho AF, Cavalcante JL, Castelo MS, Lima MC. Augmentation strategies for treatment-resistant depression: a literature review. J Clin Pharm Ther 2007;32:415-428. This is a comprehensive review of the augmentation strategies tested for TRD in which uncontrolled data and neurobiological mechanisms are included.
9. Berlim MT, Turecki G. What is the meaning of treatment resistant/refractory major depression (TRD)? A systematic review of current randomized trials. Eur Neuropsychopharmacol 2007; 17:696-707. This systematic review accounts for the heterogeneity of definitions for TRD employed in controlled clinical trials.
10. De Montigny C, Grunberg F, Mayer A, Deschenes JP. Lithium induces rapid relief of depression in tricyclic antidepressant drug nonresponders. Br J Psychiatry 1981; 138:252-256.
11. Bschor T, Bauer M. Efficacy and mechanisms of action of lithium augmentation in refractory major depression. Curr Pharm Des 2006; 12:2985-2992.
12. Crossley NA, Bauer M. Acceleration and augmentation of antidepressants with lithium for depressive disorders: two meta-analyses of randomized, placebo-controlled trials. J Clin Psychiatry 2007; 68:935-940. This is an up-to-date meta-analysis on lithium augmentation for TRD. This study also investigated the efficacy of lithium for acceleration of response to anti-depressants.
13. Nierenberg AA, Fava M, Trivedi MH, et al. A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR*D report. Am J Psychiatry 2006; 163:1519-1530.
14. Altshuler LL, Bauer M, Frye MA, et al. Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature. Am J Psychiatry 2001; 158:1617-1622.
15. Aronson R, Offman HJ, Joffe RT, Naylor CD. Triiodothyronine augmentation in the treatment of refractory depression. A meta-analysis. Arch Gen Psychiatry 1996; 53:842-848.
16. Cooper-Kazaz R, Apter JT, Cohen R, et al. Combined treatment with sertraline and liothyronine in major depression: a randomized, double-blind, placebo-controlled trial. Arch Gen Psychiatry 2007; 64:679-688.
17. Postemak M, Novak S, Stern R, et al. A pilot effectiveness study: placebo-controlled trial of adjunctive L-triiodothyronine (T3) used to accelerate and potentiate the antidepressant response. Int J Neuropsychopharmacol 2008; 11:15-25.
18. Appelhof BC, Brouwer JP, van Dyck R, et al. Triiodothyronine addition to paroxetine in the treatment of major depressive disorder. J Clin Endocrinol Metab 2004; 89:6271-6276.
19. Joffe RT, Sokolov ST, Levitt AJ. Lithium and triiodothyronine augmentation of antidepressants. Can J Psychiatry 2006; 51:791-793.
20. Bourin M, Le Melledo JM, Malinge M. Experimental and clinical pharmacology of psychostimulants. Can J Psychiatry 1995; 40:401-410.
21. Patkar AA, Masand PS, Pae CU, et al. A randomized, double-blind, placebo-controlled trial of augmentation with an extended release formulation of methylphenidate in outpatients with treatment-resistant depression. J Clin Psychopharmacol 2006; 26:653-656.
22. Ravindran AV, Kennedy SH, O'Donovan MC, et al. Osmotic-release oral system methylphenidate augmentation of antidepressant monotherapy in major depressive disorder: results of a double-blind, randomized, placebo-controlled trial. J Clin Psychiatry 2008; 69:87-94. This was a large RCT (n = 145) that studied the effects of an extended-release formulation of methylphenidate as an augmentation strategy for TRD.
23. Lam JY, Freeman MK, Cates ME. Modafinil augmentation for residual symptoms of fatigue in patients with a partial response to antidepressants. Ann Pharmacother 2007; 41:1005-1012.
24. DeBattista C, Doghramji K, Menza MA, et al. Adjunct modafinil for the short-term treatment of fatigue and sleepiness in patients with major depressive disorder: a preliminary double-blind, placebo-controlled study. J Clin Psychiatry 2003; 64:1057-1064.
25. Fava M, Thase ME, DeBattista C. A multicenter, placebo-controlled study of modafinil augmentation in partial responders to selective serotonin reuptake inhibitors with persistent fatigue and sleepiness. J Clin Psychiatry 2005; 66:85-93.
26. Thase ME, Fava M, DeBattista C, et al. Modafinil augmentation of SSRI therapy in patients with major depressive disorder and excessive sleepiness and fatigue: a 12-week, open-label, extension study. CNS Spectr 2006; 11:93-102.
27. Fava M, Thase ME, DeBattista C, et al. Modafinil augmentation of selective serotonin reuptake inhibitor therapy in MDD partial responders with persistent fatigue and sleepiness. Ann Clin Psychiatry 2007; 19:153-159. This study reports a pooled analysis of two RCTs of modafinil augmentation for TRD.
28. Nelson JC. Augmentation strategies in depression 2000. J Clin Psychiatry 2000; 61 (Suppl 2):13-19.
29. Landen M, Bjorling G, Agren H, Fahlen T. A randomized, double-blind, placebo-controlled trial of buspirone in combination with an SSRI in patients with treatment-refractory depression. J Clin Psychiatry 1998; 59:664-668.
30. Trivedi MH, Fava M, Wisniewski SR, et al. Medication augmentation after the failure of SSRIs for depression. N Engl J Med 2006; 354:1243-1252.
31. Shelton RC, Papakostas GI. Augmentation of antidepressants with atypical antipsychotics for treatment-resistant major depressive disorder. Acta Psychiatr Scand 2008; 117:253-259.
32. Papakostas GI, Shelton RC, Smith J, Fava M. Augmentation of antidepressants with atypical antipsychotic medications for treatment-resistant major depressive disorder: a meta-analysis. J Clin Psychiatry 2007; 68:826-831. This meta-analysis tested the efficacy of atypical antipsychotics as augmenting agents for TRD. Ten RCTs met inclusion criteria.
33. Mahmoud RA, Pandina GJ, Turkoz I, et al. Risperidone for treatment-refractory major depressive disorder: a randomized trial. Ann Intern Med 2007; 147:593-602. This is one of the largest (n = 274) trials on augmentation therapies for TRD ever published. The data support the efficacy of risperidone augmentation for TRD.
34. Berman RM, Marcus RN, Swanink R, et al. The efficacy and safety of aripiprazole as adjunctive therapy in major depressive disorder: a multicenter, randomized, double-blind, placebo-controlled study. J Clin Psychiatry 2007; 68:843-853. This large-scale, randomized, double-blind, placebo-controlled trial supports the efficacy of aripiprazole augmentation for TRD.
35. Marcus RN, McQuade RD, William C, et al. The efficacy and safety of aripiprazole as adjunctive treatment in major depressive disorder: a second multicenter, randomized, double-blind, placebo-controlled study. J Clin Psychopharmacol 2008; 28:243-245. This second large-scale, multicenter, double-blind, randomized, placebo-controlled trial further supported the efficacy of aripiprazole as an augmenting agent for TRD.
36. Newcomer JW. Metabolic considerations in the use of antipsychotic medications: a review of recent evidence. J Clin Psychiatry 2007; 68 (Suppl 1):20-27.
37. Keck PE Jr, McElroy SL, Strakowski SM, Soutullo CA. Antipsychotics in the treatment of mood disorders and risk of tardive dyskinesia. J Clin Psychiatry 2000; 61 (Suppl 4):33-38.
38. Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs 2004; 64:2291-2314.
39. Ballesteros J, Callado LF. Effectiveness of pindolol plus serotonin uptake inhibitors in depression: a meta-analysis of early and late outcomes from randomised controlled trials. J Affect Disord 2004; 79:137-147.
40. Geretsegger C, Bitterlich W, Stelzig R, et al. Paroxetine with pindolol augmentation: a double-blind, randomized, placebo-controlled study in depressed in-patients. Eur Neuropsychopharmacol 2008; 18:141-146.
41. Barbae JG, Jamhour NJ. Lamotrigine as an augmentation agent in treatment-resistant depression. J Clin Psychiatry 2002; 63:737-741.
42. Gutierrez RL, McKercher RM, Galea J, Jamison KL. Lamotrigine augmentation strategy for patients with treatment-resistant depression. CNS Spectr 2005; 10:800-805.
43. Gabriel A. Lamotrigine adjunctive treatment in resistant unipolar depression: an open, descriptive study. Depress Anxiety 2006; 23:485-488.
44. Barbosa L, Berk M, Vorster M. A double-blind, randomized, placebo-controlled trial of augmentation with lamotrigine or placebo in patients concomitantly treated with fluoxetine for resistant major depressive episodes. J Clin Psychiatry 2003; 64:403-407.
45. Santos MA, Rocha FL, Hara C. Efficacy and safety of antidepressant augmentation with lamotrigine in patients with treatment-resistant depression: a randomized, placebo-controlled, double-blind study. Prim Care Companion J Clin Psychiatry 2008; 10:187-190. In this randomized, double-blind, placebo-controlled trial, lamotrigine was ineffective as an augmenting agent for TRD.
46. Pope HG Jr, Cohane GH, Kanayama G, et al. Testosterone gel supplementation for men with refractory depression: a randomized, placebo-controlled trial. Am J Psychiatry 2003; 160:105-111.
47. Orengo CA, Fullerton L, Kunik ME. Safety and efficacy of testosterone gel 1% augmentation in depressed men with partial response to antidepressant therapy. J Geriatr Psychiatry Neurol 2005; 18:20-24.
48. Seidman SN, Rabkin JG. Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression. J Affect Disord 1998; 48:157-161.
49. Morgan ML, Cook IA, Rapkin AJ, Leuchter AF. Estrogen augmentation of antidepressants in perimenopausal depression: a pilot study. J Clin Psychiatry 2005; 66:774-780.
50. Rasgon NL, Altshuler LL, Fairbanks LA, et al. Estrogen replacement therapy in the treatment of major depressive disorder in perimenopausal women. J Clin Psychiatry 2002; 63 (Suppl 7):45-48.
51. Dias RS, Kerr-Correa F, Moreno RA, et al. Efficacy of hormone therapy with and without methyltestosterone augmentation of venlafaxine in the treatment of postmenopausal depression: a double-blind controlled pilot study. Menopause 2006; 13:202-211.
52. George TP, Sacco KA, Vessicchio JC, et al. Nicotinic antagonist augmentation of selective serotonin reuptake inhibitor-refractory major depressive disorder: a preliminary study. J Clin Psychopharmacol 2008; 28:340-344. This preliminary trial highlights a novel augmentation strategy for TRD. Nicotinic receptor antagonists might prove to be effective augmenting agents for TRD.