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Dr. Bob is Robert Hsiung, MD,
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Posted by djmmm on April 10, 2002, at 7:29:03
Antidepressant Switch Prompts Greater Patient Response
NEW YORK (Reuters Health) Apr 03 - Switching from imipramine hydrochloride to sertraline hydrochloride and vice versa resulted in a significant increase in the number of depressed patients who responded to therapy, according to findings reported in the March issue of the Archives of General Psychiatry.
In fact, lead researcher Dr. Michael E. Thase told Reuters Heath that "patients with very longstanding depression who had failed to respond to one vigorous trial of an antidepressant had just about as good a chance of responding to a second, different antidepressant as those who were being treated for the first time."Dr. Thase of the University of Pittsburgh School of Medicine and colleagues adopted this approach in 168 patients with chronic major depression. In a double-blind study, 117 had failed to respond to an initial 12 weeks of treatment with sertraline, the remaining 51 had failed to respond to treatment with imipramine.
Patients were then crossed over to the alternative medication and went on to have an additional 12 weeks of double-blind treatment with a daily mean end-point dosage of 221 mg of imipramine or 163 mg of sertraline.
Overall, more than 50% of these patients responded. This, say the investigators, is "particularly noteworthy as the patients had a mean duration of more than 6 years of continuous major depressive disorder." Sertraline was better tolerated than imipramine, but response and remission rates in those who completed the study did not differ significantly between agents.
Switching antidepressants may be a useful treatment strategy in nonresponders, the investigators conclude. Dr. Thase added that "the finding illustrates the importance of persistence and not giving up if the first treatment experience goes poorly."
Arch Gen Psychiatry 2002;59:233-239.
Posted by jane d on April 10, 2002, at 15:50:29
In reply to AD Switch Prompts Greater Patient Response, posted by djmmm on April 10, 2002, at 7:29:03
Did they switch all the non responders? If not, how many of the subjects who continued on the same AD for an additional 12 weeks responed in that time? Anybody know?
This is the end of the thread.
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