Ziprasidone augmentation of Selective Serotonin Reuptake Inhibitors (SSRIs) for SSRI-resistant major depressive disorder

George I. Papakostas, Timothy J. Petersen, Andrew A. Nierenberg, Jessica L. Murakami, Jonathan E. Alpert, Jerrold F. Rosenbaum, Maurizio Fava

Research output: Contribution to journalArticle

145 Citations (Scopus)

Abstract

Background: Due to their favorable side-effect profile, atypical antipsychotic agents offer important therapeutic advantages in mood disorders. Ziprasidone, an atypical antipsychotic agent with strong 5-HT1A agonist activity, may be particularly useful when used in conjunction with standard antidepressants in treatment-resistant depression. The purpose of this study is to test this hypothesis in depressed outpatients who have not experienced significant clinical improvement following an adequate trial of a selective serotonin reuptake inhibitor (SSRI). Method: Twenty patients with major depressive disorder (MDD) who had failed to experience a clinical response to an adequate trial of an SSRI were treated with open-label ziprasidone in addition to their SSRI for 6 weeks between February 2002 and December 2002. MDD was diagnosed with the Structured Clinical Interview for DSM-IV Axis I disorders. Clinical response was defined as a 50% or greater decrease in depressive symptoms during the course of the trial (baseline to endpoint), as measured by the HAM-D-17 total score. Results: Thirteen of 20 patients (65.0%) completed the trial. Using a completer analysis, 8 patients (61.5%) were classified as responders. An intent-to-treat (ITT) analysis resulted in 10 responders (50.0%). The overall proportion of remitters was 5 of 13 (38.5%) using a completer analysis and 5 of 20 (25.0%) using the ITT analysis. Ziprasidone administration appeared to be safe, with no clinically significant QTc prolongation or severe adverse events observed in any of the study participants. Conclusion: These results suggest a possible augmentation role for ziprasidone when used in conjunction with SSRIs in SSRI-resistant MDD.

Original languageEnglish (US)
Pages (from-to)217-221
Number of pages5
JournalJournal of Clinical Psychiatry
Volume65
Issue number2
DOIs
StatePublished - Feb 2004
Externally publishedYes

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Major Depressive Disorder
Serotonin Uptake Inhibitors
Antipsychotic Agents
Treatment-Resistant Depressive Disorder
Serotonin 5-HT1 Receptor Agonists
Mood Disorders
Diagnostic and Statistical Manual of Mental Disorders
Antidepressive Agents
Outpatients
ziprasidone
Interviews
Depression

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Ziprasidone augmentation of Selective Serotonin Reuptake Inhibitors (SSRIs) for SSRI-resistant major depressive disorder. / Papakostas, George I.; Petersen, Timothy J.; Nierenberg, Andrew A.; Murakami, Jessica L.; Alpert, Jonathan E.; Rosenbaum, Jerrold F.; Fava, Maurizio.

In: Journal of Clinical Psychiatry, Vol. 65, No. 2, 02.2004, p. 217-221.

Research output: Contribution to journalArticle

Papakostas, George I. ; Petersen, Timothy J. ; Nierenberg, Andrew A. ; Murakami, Jessica L. ; Alpert, Jonathan E. ; Rosenbaum, Jerrold F. ; Fava, Maurizio. / Ziprasidone augmentation of Selective Serotonin Reuptake Inhibitors (SSRIs) for SSRI-resistant major depressive disorder. In: Journal of Clinical Psychiatry. 2004 ; Vol. 65, No. 2. pp. 217-221.
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