본문 바로가기
KERD
논문KCI 등재

Effectiveness of Duloxetine Monotherapy Compared to Combination Therapy with Other Antidepressants in Patients with Major Depressive Disorder: A Short-Term, Retrospective Study

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류정신과학

초록

ObjectiveaaThe purpose of this study was to compare duloxetine monotherapy to combination therapy with other antidepressants in patients with major depressive disorder in a clinical, real world setting. MethodsaaAn eight-week, retrospective, multi-center study of outpatients with major depressive disorder was undertaken. After screening 415 patients, enrolled in this study from July 2009 to June 2014 were 82 patients from among three centers who had been taking duloxetine with or without other antidepressant and not administered with atypical antipsychotics. We compared the mean changes of the Clinical Global Impression-Severity Scale (CGI-S) as a primary measure and the discontinuation rate as a secondary measure between the duloxetine monotherapy group (n=36, 43.9%) and the combination therapy with other antidepressants group (n=46, 56.1%) at baseline, one, two, four and eight weeks. ResultsaaThere were no significant differences across the demographic characteristics between two groups. There was, however, a statistically greater improvement on the CGI-S at weeks 2, 4 and 8 in the combination group compared with the monotherapy group. There were no significant differences in discontinuation rate and adverse events between two groups. No serious adverse events were reported in both groups during the study period. ConclusionaaThis result suggests that the duloxetine combination therapy with other antidepressants could improve effectiveness and have comparable tolerability with the monotherapy in the treatment of outpatients with major depressive disorders in a naturalistic setting. Adequately powered, well-controlled clinical trials are strongly warranted to confirm our findings due to methodological shortcomings.

Abstract

ObjectiveaaThe purpose of this study was to compare duloxetine monotherapy to combination therapy with other antidepressants in patients with major depressive disorder in a clinical, real world setting. MethodsaaAn eight-week, retrospective, multi-center study of outpatients with major depressive disorder was undertaken. After screening 415 patients, enrolled in this study from July 2009 to June 2014 were 82 patients from among three centers who had been taking duloxetine with or without other antidepressant and not administered with atypical antipsychotics. We compared the mean changes of the Clinical Global Impression-Severity Scale (CGI-S) as a primary measure and the discontinuation rate as a secondary measure between the duloxetine monotherapy group (n=36, 43.9%) and the combination therapy with other antidepressants group (n=46, 56.1%) at baseline, one, two, four and eight weeks. ResultsaaThere were no significant differences across the demographic characteristics between two groups. There was, however, a statistically greater improvement on the CGI-S at weeks 2, 4 and 8 in the combination group compared with the monotherapy group. There were no significant differences in discontinuation rate and adverse events between two groups. No serious adverse events were reported in both groups during the study period. ConclusionaaThis result suggests that the duloxetine combination therapy with other antidepressants could improve effectiveness and have comparable tolerability with the monotherapy in the treatment of outpatients with major depressive disorders in a naturalistic setting. Adequately powered, well-controlled clinical trials are strongly warranted to confirm our findings due to methodological shortcomings.

참고문헌 (21)

  1. Agency for Health Care Policy and Research. Depression in Primary Care, "United States. Depression Guideline Panel", US Deptartment of Health and Human Services, ~ (1993)
  2. Rush AJ, "Combining medications to enhance depression outcomes(CO-MED) : acute and long-term outcomes of a single-blind randomized study", Am J Psychiatry, 168, pp.689~701 (2011)
  3. Rush AJ, "Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps : a STAR*D report", Am J Psychiatry, 163, pp.1905~1917 (2006)
  4. American Psychiatric Association, "Practice guideline for the treatment of patients with major depressive disorder (revision)", Am J Psychiatry, 157(4 Suppl), pp.1~45 (2000)
  5. Thase ME, "Antidepressant combinations: widely used, but far from empirically validated", Can J Psychiatry, 56, pp.317~323 (2011)
  6. Blier P, "Combination of antidepressant medications from treatment initiation for major depressive disorder : a double-blind randomized study", Am J Psychiatry, 167, pp.281~288 (2010)
  7. Nemeroff CB, "Duloxetine for the treatment of major depressive disorder", Psychopharmacol Bull, 36, pp.106~132 (2002)
  8. Detke MJ, "Duloxetine, 60 mg once daily, for major depressive disorder: a randomized double-blind placebo-controlled trial", J Clin Psychiatry, 63, pp.308~315 (2002)
  9. Detke MJ, "Duloxetine 60 mg once daily dosing versus placebo in the acute treatment of major depression", J Psychiatr Res, 36, pp.383~390 (2002)
  10. Detke MJ, "Duloxetine in the acute and long-term treatment of major depressive disorder : a placebo-and paroxetine-controlled trial", Eur Neuropsychopharmacol, 14, pp.457~470 (2004)
  11. Goldstein DJ, "Duloxetine in the treatment of major depressive disorder : a double-blind clinical trial", J Clin Psychiatry, 63, pp.225~231 (2002)
  12. Goldstein DJ, "Duloxetine in the treatment of depression : a double-blind placebo-controlled comparison with paroxetine", J Clin Psychopharmacol, 24, pp.389~399 (2004)
  13. Perahia DG, "Duloxetine in the prevention of relapse of major depressive disorder : double-blind placebo-controlled study", Br J Psychiatry, 188, pp.346~353 (2006)
  14. Gartlehner G, "The general and comparative efficacy and safety of duloxetine in major depressive disorder : a systematic review and meta-analysis", Drug Saf, 32, pp.1159~1173 (2009)
  15. Hudson JI, "Safety and tolerability of duloxetine in the treatment of major depressive disorder : analysis of pooled data from eight placebo-controlled clinical trials", Hum Psychopharmacol, 20, pp.327~341 (2005)
  16. Diagnostic Criteria from DSM-IV-TR, "American Psychiatric Association", American Psychiatric Association, ~ (2000)
  17. Busner J, "The clinical global impressions scale : applying a research tool in clinical practice", Psychiatry, 4, pp.28~37 (2007)
  18. Rocha FL, "Combination of antidepressants in the treatment of major depressive disorder : a systematic review and meta-analysis", J Clin Psychopharmacol, 32, pp.278~281 (2012)
  19. Rush AJ, "Combining antidepressant medications: a good idea?", Am J Psychiatry, 167, pp.241~243 (2010)
  20. Thase ME, "Combined antidepressant strategies are not more effective than vigorous escitalopram monotherapy : results of the CO-MED study", Curr Psychiatry Rep, 13, pp.434~436 (2011)
  21. Fornaro M, "Duloxetine-bupropion combination for treatment-resistant atypical depression: a double-blind, randomized, placebo-controlled trial", Eur Neuropsychopharmacol, 24, pp.1269~1278 (2014)

관련 논문AI추천

주요 정신과적 질환에서 Duloxetine 단독요법과 다른 항우울제와의 병합요법의 효과 비교 : 단기간, 후향적 연구구본훈, 이준엽, 정성윤, 천은진, 최중현대한생물치료정신의학회 · 생물치료정신의학2015 · 제21권 제3호Additional Clinical Benefit of Agomelatine Treatment for Major Depressive Disorder in Naturalistic Treatment Setting박원명, 배치운, Ashwin A. Patkar, Changsu Han, Kyung Ho Lee, Prakash S. Masand, Soo-Jung Lee, Tae Sun Han대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2023 · 제21권 제3호The Potential Utility of Aripiprazole Augmentation for Major Depressive Disorder with Mixed Features Specifier: A Retrospective StudyAshwin A Patkar, Changsu Han, Chi Un Pae, Prakash S Masand, Sheng Min Wang, Soo-Jung Lee, Won-Myong Bahk대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2019 · 제17권 제4호The Potential Role of Aripiprazole Augmentation for Major Depressive Disorder with Anxious Distress in Naturalistic Treatment Setting배치운, 이승훈, Ashwin A. Patkar, Changsu Han, Kyung Ho Lee, Prakash S. Masand, Soo-Jung Lee, Tae Sun Han, Won-Myong Bahk대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2024 · 제22권 제2호The Effect of Initial Duloxetine Dosing Strategy on Nausea in Korean Patients with Major Depressive Disorder안용민, 이민수, 정석훈, Joel Raskin, Mun Sung Kim, Richard Walton대한신경정신의학회 · PSYCHIATRY INVESTIGATION2012 · 제9권 제4호Duloxetine, a Selective Noradrenaline Reuptake Inhibitor, Increased Plasma Levels of 3-Methoxy-4-hydroxyphenylglycol but Not Homovanillic Acid in Patients with Major Depressive DisorderAsuka Katsuki, Atsuko Ikenouchi-Sugita, Hikaru Hori, Jun Nakamura, Kiyokazu Atake, Reiji Yoshimura, Wakako Umene-Nakano대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2014 · 제12권 제1호

이 간행물의 다른 논문 (9건)