Adding Antipsychotic Could Help Elderly With Treatment-Resistant Depression
Previous research has suggested that younger patients with treatment-resistant depression benefit from aripiprazole as an add-on therapy, and a new study in The Lancet confirms that a greater number of older adults also achieved remission with aripiprazole compared to placebo as augmentation pharmacotherapy.
Eric J. Lenze, MD, from the Washington University School of Medicine in St. Louis, and colleagues conducted a randomized, double-blind, placebo-controlled multi-center trial (n=468) to evaluate the safety and efficacy of aripiprazole as an add-on therapy for treatment-resistant major depression in adults aged ≥60. Patients who did not achieve remission during a 12-week pre-trial with venlafaxine extended-release (150–300mg/day) were randomly assigned to the addition of aripiprazole (target dose 10mg, maximum 15mg daily) or placebo for 12 weeks.
A total of 44% of patients in the venlafaxine + aripiprazole arm achieved remission compared to 29% receiving venlafaxine + placebo. Aripiprazole was also associated with more Parkinsonism (17% vs. 2%), but not with treatment-emergent suicidal ideation (21% vs. 29%) or other measured safety variables.
Aripiprazole is an atypical antipsychotic indicated for the treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar I disorder, adjunctive treatment of major depressive disorder, irritability associated with autistic disorder, and treatment of Tourette's disorder.
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