Specific depressive symptoms predict remission to aripiprazole augmentation in late-life treatment resistant depression.

Abstract:

OBJECTIVE:To identify which specific depressive symptoms predict remission to aripiprazole augmentation in late-life treatment resistant depression. METHODS:This is a secondary analysis of data from a late-life treatment resistant depression trial examining the safety and efficacy of aripiprazole augmentation. Participants aged 60 and above were randomized to aripiprazole augmentation (N = 91) versus placebo (N = 90). The main outcome was depression remission. Clinical predictors included individual Montgomery-Asberg Depression Rating Scale (MADRS) item scores categorized as symptomatic (scores >2) or nonsymptomatic (scores ≤2). RESULTS:Three MADRS items predicted depression remission with aripiprazole augmentation: symptomatic scores on sleep disturbance and nonsymptomatic scores on apparent sadness and inability to feel. The 2-way and 3-way interaction terms of these MADRS items were not significant predictors of remission; therefore, the models' ability to predict remission was not improved by combining the significant MADRS items. CONCLUSIONS:The identification of specific depressive symptoms, which can be clinically assessed, can be used to inform treatment decisions. Older adults with treatment resistant depression that present with sleep disturbances, lack of apparent sadness, or lack of inability to feel should be considered for aripiprazole augmentation.

authors

Gebara MA,DiNapoli EA,Kasckow J,Karp JF,Blumberger DM,Lenze EJ,Mulsant BH,Reynolds CF 3rd

doi

10.1002/gps.4813

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

e330-e335

issue

2

eissn

0885-6230

issn

1099-1166

journal_volume

33

pub_type

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