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Adjuvant Aripiprazole Beneficial in Tx-Resistant Depression

Addition of aripiprazole effective for achieving remission in adults aged older than 60 years

WEDNESDAY, Sept. 30, 2015 (HealthDay News) — Adjuvant aripiprazole is associated with achievement of remission among older adults with treatment-resistant depression, according to a study published online Sept. 27 in The Lancet.

Eric J. Lenze, M.D., from the Washington University School of Medicine in St. Louis, and colleagues examined whether aripiprazole is associated with a higher probability of remission than placebo in adults aged older than 60 years with treatment-resistant depression. Participants were treated during a pre-trial with venlafaxine extended-release and those who did not achieve remission were randomized to the addition of aripiprazole (91 patients) or placebo (90 patients) for 12 weeks. Remission was assessed as the primary end point, and was defined as a Montgomery Asberg Depression Rating Scale score of 10 or less (and at least 2 points below the score at randomization).

The researchers found that a greater proportion of participants in the aripiprazole group versus the placebo group achieved remission (44 versus 29 percent; odds ratio, 2.0). The most common adverse effect of aripiprazole was akathisia (reported in 26 percent versus 1 percent in the placebo group). Aripiprazole also correlated with more Parkinsonism (17 versus 2 percent), but not with treatment-emergency suicidal ideation (21 versus 29 percent) or with other safety variables.

“The addition of aripiprazole is effective in achieving and sustaining remission,” the authors write. “Tolerability concerns include the potential for akathisia and Parkinsonism.”

Several authors disclosed financial ties to pharmaceutical companies, including Bristol-Myers Squibb, the manufacturer of aripiprazole.

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