Treatment patterns in major depressive disorder after an inadequate response to first-line antidepressant treatment

BMC Psychiatry

Research Article

Jorge Maurino¹  Esteban Medina¹  Mauro Garcia-Toro²  Jaime L Galan³  Miguel A Gonzalez⁴ 

[1] AstraZeneca Medical Department, Madrid, Spain;Department of Psychiatry, Hospital Son Llatzer, Palma de Mallorca, Spain;Hospital Quirón, Málaga, Spain;Quintiles, Madrid, Spain;

关键词: Major depressive disorder;    Response;    Antidepressant treatment;    Augmentation;    Switching;    Combination;   

DOI  :  10.1186/1471-244X-12-143

 received in 2012-04-30, accepted in 2012-09-13,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe aim of the study was to determine the most common pharmacological strategies used in the management of major depressive disorder (MDD) after an inadequate response to first-line antidepressant treatment in clinical practice.MethodsMulticenter, non-interventional study in adult outpatients with a DSM-IV-TR diagnosis of MDD and inadequate response to first-line antidepressant medication. Multiple logistic regression analyses were performed to identify independent factors associated with the adoption of a specific second-line strategy.ResultsA total of 273 patients were analyzed (mean age: 46.8 years, 67.8% female). Baseline mean Montgomery-Asberg Depression Rating Scale total score was 32.1 (95%CI 31.2-32.9). The most common strategies were: switching antidepressant medication (39.6%), augmentation (18.8%), and combination therapy (17.9%). Atypical antipsychotic drugs were the most commonly used agent for augmenting antidepressant effect. The presence of psychotic symptoms and the number of previous major depressive episodes were associated with the adoption of augmenting strategy (OR = 3.2 and 1.2, respectively).ConclusionThe switch to another antidepressant agent was the most common second-line therapeutic approach. Psychiatrists chose augmentation based on a worse patients’ clinical profile (number of previous episodes and presence of psychotic symptoms).

【 授权许可】

Unknown   
© Garcia-Toro et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.