For some patients who have undergone rounds of monotherapy for major depressive disorder (MDD), achieving remission may require the use of adjunctive treatment strategies. A study published Thursday in AJP in Advance shows that the atypical antipsychotic ziprasidone may serve as a potential strategy.
Researchers from the Massachusetts General Hospital Clinical Trails Network, the Mayo School of Medicine, and the University of Alabama-Birmingham School of Medicine conducted a multisite study to test the efficacy of adjunctive ziprasidone in 139 adults who remained symptomatic for nonpsychotic unipolar MDD after receiving treatment with the antidepressant escitalopram. The patients were divided into two groups: one group received escitalopram plus ziprasidone for eight weeks; the other received escitalopram plus placebo. The primary outcome measure was clinical response, defined as a reduction of at least 50% in score on the 17-item Hamilton Depression Rating Scale (HAM-D).
At eight weeks, the analysis showed that symptoms of depression were significantly more likely to have improved from baseline in the escitalopram plus ziprasidone group than the escitalopram plus placebo group. Improvements in symptoms of anxiety were also significantly greater in the escitalopram plus ziprasidone cohort than the escitalopram plus placebo cohort. Approximately 14% of the patients in the escitalopram plus ziprasidone group discontinued treatment because of intolerance compared with none in the escitalopram plus placebo group.
“These results suggest that, similar to other atypical antipsychotic agents, adjunctive ziprasidone can represent a useful treatment option for patients with major depressive disorder,” the researchers noted. Due to the rates of discontinuance for the escitalopram plus ziprasidone, the researchers emphasized that more studies testing different dosing regimens are merited.