Study compares switching meds vs. an additional med for patients unresponsive to an antidepressant

July 11, 2017

Among patients unresponsive to an antidepressant medication, adding the antipsychotic aripiprazole modestly increased the likelihood of remission from depression compared to switching to the antidepressant bupropion, according to a study published by JAMA.

Major depressive disorder (MDD) is a chronic, debilitating disorder that affected an estimated 16 million adults in the United States in 2015. Less than one-third of patients achieve remission with their first antidepressant. Somaia Mohamed, M.D., Ph.D., of the VA Connecticut Healthcare System, West Haven, Conn., and colleagues randomly assigned 1,522 patients at 35 U.S. Veterans Health Administration medical centers diagnosed with MDD and unresponsive to at least one antidepressant to switch to a different antidepressant (; n = 511); augment current treatment with bupropion (n = 506); or augment with aripiprazole (n = 505) for 12 weeks (treatment phase) and evaluated for up to 36 weeks.

Among the (average age, 54 years; men, 85 percent), 75 percent completed the treatment phase. Depression remission rates at 12 weeks were 22.3 percent for the switch group, 26.9 percent for the augment-bupropion group, and 28.9 percent for the augment¬ aripiprazole group. Symptom improvement was greater for the augment-aripiprazole group than for either the switch group or the augment-bupropion group.

Anxiety was more frequent in the two bupropion groups.

Adverse effects more frequent in the augment-aripiprazole group included drowsiness, restlessness and weight gain."Given the small effect size and adverse effects associated with , further analysis including cost-effectiveness is needed to understand the net utility of this approach," the authors write.

A limitation of the study was that only one antidepressant and one antipsychotic were evaluated, and the generalizability of the results to other medications is unknown.

Explore further: No difference in side-effects when switching or adding antidepressants

More information: JAMA (2017). jamanetwork.com/journals/jama/ … .1001/jama.2017.8036

Related Stories

No difference in side-effects when switching or adding antidepressants

November 18, 2011
Patients with major depression who fail to see improvement after taking an antidepressant often have their initial medication switched or combined with a second drug. Many clinicians weigh the possibility of adverse side ...

One antidepressant shown to control weight during two-year study

April 20, 2016
Group Health researchers have found that bupropion (marketed as Wellbutrin) is the only antidepressant that tends to be linked to long-term modest weight loss.

Aripiprazole reduces severity of tics in children with Tourette's disorder

July 20, 2016
A meta-analysis of clinical trials evaluating the effectiveness of aripiprazole for the treatment of Tourette's disorder (TD) in children and adolescents showed a significantly greater overall improvement in total tics and ...

Dual medications for depression increases costs, side effects with no benefit to patients

May 2, 2011
Taking two medications for depression does not hasten recovery from the condition that affects 19 million Americans each year, researchers at UT Southwestern Medical Center have found in a national study.

Researchers find antidepressant bupropion crosses placenta

October 19, 2016
(HealthDay)—In pregnant women taking the antidepressant bupropion, the drug and its active metabolites cross the placenta to the fetal circulation, according to a study published in the October issue of the American Journal ...

Brexpiprazole provides new second-line treatment options for patients with major depressive disorder

August 27, 2015
Brexpiprazole, an antipsychotic drug approved this summer by the U.S. Food and Drug Administration, is an effective and well-tolerated addition to conventional first-line antidepressants for the treatment of major depressive ...

Recommended for you

Babies can learn that hard work pays off

September 21, 2017
If at first you don't succeed, try, try again. A new study from MIT reveals that babies as young as 15 months can learn to follow this advice. The researchers found that babies who watched an adult struggle at two different ...

Study links brain inflammation to suicidal thinking in depression

September 21, 2017
Patients with major depressive disorder (MDD) have increased brain levels of a marker of microglial activation, a sign of inflammation, according to a new study in Biological Psychiatry by researchers at the University of ...

Oxytocin turns up the volume of your social environment

September 20, 2017
Before you shop for the "cuddle" hormone oxytocin to relieve stress and enhance your social life, read this: a new study from the University of California, Davis, suggests that sometimes, blocking the action of oxytocin in ...

Researchers develop new tool to assess individual's level of wisdom

September 20, 2017
Researchers at University of San Diego School of Medicine have developed a new tool called the San Diego Wisdom Scale (SD-WISE) to assess an individual's level of wisdom, based upon a conceptualization of wisdom as a trait ...

Self-control may not diminish throughout the day

September 20, 2017
After a long day of work and carefully watching what you eat, you might expect your self-control to slip a little by kicking back and cracking open a bag of potato chips.

Alcohol use affects levels of cholesterol regulator through epigenetics

September 20, 2017
In an analysis of the epigenomes of people and mice, researchers at Johns Hopkins Medicine and the National Institutes of Health report that drinking alcohol may induce changes to a cholesterol-regulating gene.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.