TY - JOUR
T1 - A pilot, open study of sertraline in outpatients with treatment-resistant depression (TRD) or with a history of TRD who responded but later relapsed
AU - Papakostas, George I.
AU - Petersen, Timothy
AU - Worthington, John J.
AU - Roffi, Pamela A.
AU - Alpert, Jonathan E.
AU - Fava, Maurizio
AU - Nierenberg, Andrew A.
PY - 2003/9
Y1 - 2003/9
N2 - While most depressed patients are prescribed a selective serotonin reuptake inhibitor (SSRI) as an initial treatment, the use of SSRIs as a second or third-line treatment for depression is not as prevalent. This trial assessed the efficacy of sertraline for patients with treatment-resistant depression (TRD) or patients with a history of TRD who responded but later relapsed. Twelve patients with TRD who had not responded to a number of antidepressant trials (n = 7), or had responded but subsequently suffered a relapse (n = 5), were enrolled in an 8-week, open trial of sertraline. Both a completer analysis (n = 6) and an intent-to-treat (ITT) analysis (n = 12) were performed to evaluate sertraline response rates. Using a completer analysis, four patients (66.6%) were classified as responders; one (16.7%) as a partial responder and one (16.7%) as a non-responder. An ITT analysis resulted in five (41.7%) patients being classified as responders; one (8.3%) as a partial responder and six (50%) as non-responders. Of the four responders in the completer analysis, three (50%) achieved remission. Of the five responders in the ITT analysis, four (33.3%) achieved remission. Overall, two of seven (28.6%) non-responders and three of five (60.0%) relapsers responded to sertraline. The present results suggest the potential utility of sertraline for patients with TRD, or those with a history of TRD who responded but later relapsed, and warrant larger, placebo-controlled studies to further explore the potential role of sertraline for such patients.
AB - While most depressed patients are prescribed a selective serotonin reuptake inhibitor (SSRI) as an initial treatment, the use of SSRIs as a second or third-line treatment for depression is not as prevalent. This trial assessed the efficacy of sertraline for patients with treatment-resistant depression (TRD) or patients with a history of TRD who responded but later relapsed. Twelve patients with TRD who had not responded to a number of antidepressant trials (n = 7), or had responded but subsequently suffered a relapse (n = 5), were enrolled in an 8-week, open trial of sertraline. Both a completer analysis (n = 6) and an intent-to-treat (ITT) analysis (n = 12) were performed to evaluate sertraline response rates. Using a completer analysis, four patients (66.6%) were classified as responders; one (16.7%) as a partial responder and one (16.7%) as a non-responder. An ITT analysis resulted in five (41.7%) patients being classified as responders; one (8.3%) as a partial responder and six (50%) as non-responders. Of the four responders in the completer analysis, three (50%) achieved remission. Of the five responders in the ITT analysis, four (33.3%) achieved remission. Overall, two of seven (28.6%) non-responders and three of five (60.0%) relapsers responded to sertraline. The present results suggest the potential utility of sertraline for patients with TRD, or those with a history of TRD who responded but later relapsed, and warrant larger, placebo-controlled studies to further explore the potential role of sertraline for such patients.
KW - Antidepressant non-response
KW - Depression
KW - Medication switch
KW - Refractory depression
KW - SSRI
KW - Sertraline
KW - Treatment-resistant
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U2 - 10.1097/00004850-200309000-00006
DO - 10.1097/00004850-200309000-00006
M3 - Article
C2 - 12920390
AN - SCOPUS:0041327979
SN - 0268-1315
VL - 18
SP - 293
EP - 296
JO - International Clinical Psychopharmacology
JF - International Clinical Psychopharmacology
IS - 5
ER -