The atypical antipsychotic drug Abilify (aripiprazole) appears to enhance the response to antidepressants in patients with treatment-resistant major depression, research suggests.
Atypical antipsychotic agents are often used to augment antidepressants among patients with refractory mood disorders, lead author Dr. George I. Papakostas and colleagues note in their report, published in the Journal of Clinical Psychiatry.
Abilify is unique among the atypical antipsychotics and therefore may be more effective than other drugs in its class. It may also have a better adverse effect profile, Papakostas said in an interview.
He explained: “Studies conducted so far in schizophrenia and bipolar disorder suggest that agents such as aripiprazole and ziprasadone (Geodon) may have advantages in terms of less weight gain ... stiffness, and lipid abnormalities compared with other atypical antipsychotic agents, including olanzapine (Zyprexa), clozapine (Clozaril), quetiapine (Seroquel), and risperidone (Risperdal).”
Papakostas’ team recruited 12 patients who had been treated with an antidepressant for a minimum of 6 weeks but still had significant symptoms of depression.
Patients were started on Abilify at doses of 10 to 15 milligrams, up to a maximum daily dose of 30 milligrams, for a total of 8 weeks.
According to the team, there were seven responders, defined as having a 50 percent or greater reduction in depressive symptoms, and five patients who went into remission.
“When we examined the rate of change of depressive symptoms over time, improvement with aripiprazole appeared robust and rapid, with a considerable proportion of overall improvement having occurred within the first week of treatment,” the authors note.
In a second paper in the Journal, Dr. Jeffrey S. Smith from Northbrooke Research Center in Brown Deer, Wisconsin, and Dr. Charles B. Nemeroff, from Emory University School of Medicine in Atlanta, performed a similar study that included 15 patients who had been taking an antidepressant for at least 8 weeks. Doses of Abilify ranged between 2.5 and 10 milligrams daily.
By week 8, 14 patients had responded to treatment, and seven achieved remission.
SOURCE: Journal of Clinical Psychiatry, October 2005.
Revision date: July 8, 2011
Last revised: by Jorge P. Ribeiro, MD