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Ziprasidone augmentation for anxious depression

Ionescu, Dawn F.; Shelton, Richard C.; Baer, Lee; Meade, Kathryn H.; Swee, Michaela B.; Fava, Maurizio; Papakostas, George I.

International Clinical Psychopharmacology: November 2016 - Volume 31 - Issue 6 - p 341–346
doi: 10.1097/YIC.0000000000000133
ORIGINAL ARTICLES
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Previously, we found an anxiolytic effect of ziprasidone augmentation to escitalopram (compared with placebo augmentation) in patients with depression in an 8-week, randomized, double-blind, parallel-group, placebo-controlled trial. Here, we carried out a post-hoc analysis, comparing changes in the Hamilton Depression and Anxiety Rating Scales between patients with anxious depression versus nonanxious depression, using a moderator analysis. Hamilton Depression Rating Scales total change scores from baseline and endpoint were not significantly different (interaction term P=0.91) in patients with anxious depression on ziprasidone augmentation (n=19; −9.1±4.9) or placebo (n=19; −6.1±8.9) versus patients without anxious depression on ziprasidone (n=52; −5.5±6.7) or placebo (n=49; −2.3±4.5). There was a trend toward statistical significance (interaction term P=0.1) in favor of patients without anxious depression for a difference in Hamilton Anxiety Rating Scale total change scores from baseline to endpoint [patients with anxious depression on ziprasidone augmentation (n=19; −2.7±5.3) or placebo (n=19; −3.3±5.8) versus patients without anxious depression on ziprasidone (n=51; −3.9±6.6) or placebo (n=44; −0.9±4.7)]. Ziprasidone augmentation was equally efficacious in treating depression in patients with versus without anxious depression. However, the observed anxiolytic effect for patients with higher anxiety was not clinically significant.

aDepartment of Psychiatry, Massachusetts General Hospital

bHarvard Medical School, Boston, Massachusetts

cDepartment of Psychiatry, Office of Psychiatric Clinical Research, University of Alabama at Birmingham, Birmingham, Alabama, USA

Correspondence to Dawn F. Ionescu, MD, Massachusetts General Hospital, Depression Clinical and Research Program (DCRP), 1 Bowdoin Square, 6th Floor, Boston, MA 02114, USA Tel: +1 617 643 0491; fax: +1 617 724 3028; e-mail: dionescu@mgh.harvard.edu

Received March 4, 2016

Accepted April 18, 2016

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