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Comparative effectiveness research trial for antidepressant incomplete and non-responders with treatment resistant depression (ASCERTAIN-TRD) a randomized clinical trial.
Papakostas, George I; Trivedi, Madhukar H; Shelton, Richard C; Iosifescu, Dan V; Thase, Michael E; Jha, Manish K; Mathew, Sanjay J; DeBattista, Charles; Dokucu, Mehmet E; Brawman-Mintzer, Olga; Currier, Glenn W; McCall, William Vaughn; Modirrousta, Mandana; Macaluso, Matthew; Bystritsky, Alexander; Rodriguez, Fidel Vila; Nelson, Erik B; Yeung, Albert S; Feeney, Anna; MacGregor, Leslie C; Carmody, Thomas; Fava, Maurizio.
Afiliación
  • Papakostas GI; Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. gpapakostas@mgb.org.
  • Trivedi MH; University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Shelton RC; University of Alabama at Birmingham, Birmingham, AL, USA.
  • Iosifescu DV; Nathan Kline Institute for Psychiatric Research and New York University School of Medicine, New York, NY, USA.
  • Thase ME; Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA.
  • Jha MK; University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Mathew SJ; Baylor College of Medicine, Houston, TX, USA.
  • DeBattista C; Stanford University School of Medicine, Stanford, CA, USA.
  • Dokucu ME; Dartmouth Geisel School of Medicine, Lebanon, NH, USA.
  • Brawman-Mintzer O; Medical University of South Carolina, Charleston, SC, USA.
  • Currier GW; Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
  • McCall WV; Medical College of Georgia, Augusta, GA, USA.
  • Modirrousta M; University of Manitoba, Winnipeg, MB, Canada.
  • Macaluso M; University of Alabama at Birmingham, Birmingham, AL, USA.
  • Bystritsky A; University of Kansas School of Medicine, Wichita, KS, USA.
  • Rodriguez FV; Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, LA, USA.
  • Nelson EB; University of British Columbia, Vancouver, BC, Canada.
  • Yeung AS; University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
  • Feeney A; Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • MacGregor LC; Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Carmody T; Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Fava M; University of Texas Southwestern Medical Center, Dallas, TX, USA.
Mol Psychiatry ; 29(8): 2287-2295, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38454079
ABSTRACT
Further research is needed to help improve both the standard of care and the outcome for patients with treatment-resistant depression. A particularly critical evidence gap exists with respect to whether pharmacological or non-pharmacological augmentation is superior to antidepressant switch, or vice-versa. The objective of this study was to compare the effectiveness of augmentation with aripiprazole or repetitive transcranial magnetic stimulation versus switching to the antidepressant venlafaxine XR (or duloxetine for those not eligible to receive venlafaxine) for treatment-resistant depression. In this multi-site, 8-week, randomized, open-label study, 278 subjects (196 females and 82 males, mean age 45.6 years (SD 15.3)) with treatment-resistant depression were assigned in a 111 fashion to treatment with either of these three interventions; 235 subjects completed the study. 260 randomized subjects with at least one post-baseline Montgomery-Asberg Depression Rating (MADRS) assessment were included in the analysis. Repetitive transcranial magnetic stimulation (score change (standard error (se)) = -17.39 (1.3) (p = 0.015) but not aripiprazole augmentation (score change (se) = -14.9 (1.1) (p = 0.069) was superior to switch (score change (se) = -13.22 (1.1)) on the MADRS. Aripiprazole (mean change (se) = -37.79 (2.9) (p = 0.003) but not repetitive transcranial magnetic stimulation augmentation (mean change (se) = -42.96 (3.6) (p = 0.031) was superior to switch (mean change (se) = -34.45 (3.0)) on the symptoms of depression questionnaire. Repetitive transcranial magnetic stimulation augmentation was shown to be more effective than switching antidepressants in treatment-resistant depression on the study primary measure. In light of these findings, clinicians should consider repetitive transcranial magnetic stimulation augmentation early-on for treatment-resistant depression.Trial registration ClinicalTrials.gov, NCT02977299.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estimulación Magnética Transcraneal / Trastorno Depresivo Resistente al Tratamiento / Clorhidrato de Venlafaxina / Aripiprazol / Antidepresivos Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Mol Psychiatry Asunto de la revista: BIOLOGIA MOLECULAR / PSIQUIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estimulación Magnética Transcraneal / Trastorno Depresivo Resistente al Tratamiento / Clorhidrato de Venlafaxina / Aripiprazol / Antidepresivos Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Mol Psychiatry Asunto de la revista: BIOLOGIA MOLECULAR / PSIQUIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido