Scientists from the University of Washington have discovered that older people with clinical depression who do not respond to standard treatment may benefit from adding the antipsychotic aripiprazole to their treatment. Research published New England Journal of Medicine.
Many people with clinical depression do not respond to medication, so doctors sometimes refer such patients to another antidepressant to find an antidepressant that works. Another option is to add another class of drugs to the treatment to see if the combination helps.
Both strategies are approved for the treatment of older adults with treatment-resistant depression. A new study has shown that the second method may be more effective.
The study included 742 people aged 60 years and older with treatment-resistant depression. At the first stage, 619 patients, all of whom were using antidepressants (Prozac, Lexapro or Zoloft), were randomly divided into three groups.
In the first group, patients continued their original antidepressant treatment and additionally received aripiprazole. Aripiprazole was originally approved for the treatment of schizophrenia in the US, but has also been used at lower doses for adjunctive treatment of clinical depression in younger patients who have not responded to antidepressant treatment alone.
The second group also continued to take antidepressants but added bupropion (brand names Wellbutrin or Zyban) and the third group switched completely to bupropion.
For 10 weeks, participants called doctors or visited hospitals every two weeks to adjust treatment. At the end of the study, the researchers found that adding aripiprazole resulted in a longer-lasting improvement in depression and a greater improvement in mood in patients.
However, even this approach only helped about 30% of patients, highlighting the need to find and develop more effective treatments that could help more people.