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Treatment of unipolar psychotic depression: a randomized, double-blind study comparing imipramine, venlafaxine, and venlafaxine plus quetiapine.

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Title: Treatment of unipolar psychotic depression: a randomized, double-blind study comparing imipramine, venlafaxine, and venlafaxine plus quetiapine.
Authors: Wijkstra, J. (AUTHOR), Burger, H. (AUTHOR), Van Den Broek, W. W. (AUTHOR), Birkenhäger, T. K. (AUTHOR), Janzing, J. G. E. (AUTHOR), Boks, M. P. M. (AUTHOR), Bruijn, J. A. (AUTHOR), Van Der Loos, M. L. M. (AUTHOR), Breteler, L. M. T. (AUTHOR), Ramaekers, G. M. G. I. (AUTHOR), Verkes, R. J. (AUTHOR), Nolen, W. A. (AUTHOR)
Source: Acta Psychiatrica Scandinavica. Mar2010, Vol. 121 Issue 3, p190-200. 11p. 1 Diagram, 3 Charts, 2 Graphs.
Subjects: Psychotic depression, Antidepressants, Imipramine, Venlafaxine, Mental health, Therapeutics
Abstract: Wijkstra J, Burger H, van den Broek WW, Birkenhäger TK, Janzing JGE, Boks MPM, Bruijn JA, van der Loos MLM, Breteler LMT, Ramaekers GMGI, Verkes RJ, Nolen WA. Treatment of unipolar psychotic depression: a randomized, double-blind study comparing imipramine, venlafaxine, and venlafaxine plus quetiapine. Objective: It remains unclear whether unipolar psychotic depression should be treated with an antidepressant and an antipsychotic or with an antidepressant alone. Method: In a multi-center RCT, 122 patients (18–65 years) with DSM-IV-TR psychotic major depression and HAM-D-17 ≥ 18 were randomized to 7 weeks imipramine (plasma-levels 200–300 μg/l), venlafaxine (375 mg/day) or venlafaxine–quetiapine (375 mg/day, 600 mg/day). Primary outcome was response on HAM-D-17. Secondary outcomes were response on CGI and remission (HAM-D-17). Results: Venlafaxine–quetiapine was more effective than venlafaxine with no significant differences between venlafaxine–quetiapine and imipramine, or between imipramine and venlafaxine. Secondary outcomes followed the same pattern. Conclusion: That unipolar psychotic depression should be treated with a combination of an antidepressant and an antipsychotic and not with an antidepressant alone, can be considered evidence based with regard to venlafaxine–quetiapine vs. venlafaxine monotherapy. Whether this is also the case for imipramine monotherapy is likely, but cannot be concluded from the data. [ABSTRACT FROM AUTHOR]
Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Treatment of unipolar psychotic depression: a randomized, double-blind study comparing imipramine, venlafaxine, and venlafaxine plus quetiapine.
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  Data: <searchLink fieldCode="JN" term="%22Acta+Psychiatrica+Scandinavica%22">Acta Psychiatrica Scandinavica</searchLink>. Mar2010, Vol. 121 Issue 3, p190-200. 11p. 1 Diagram, 3 Charts, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Psychotic+depression%22">Psychotic depression</searchLink><br /><searchLink fieldCode="DE" term="%22Antidepressants%22">Antidepressants</searchLink><br /><searchLink fieldCode="DE" term="%22Imipramine%22">Imipramine</searchLink><br /><searchLink fieldCode="DE" term="%22Venlafaxine%22">Venlafaxine</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health%22">Mental health</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
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  Data: Wijkstra J, Burger H, van den Broek WW, Birkenhäger TK, Janzing JGE, Boks MPM, Bruijn JA, van der Loos MLM, Breteler LMT, Ramaekers GMGI, Verkes RJ, Nolen WA. Treatment of unipolar psychotic depression: a randomized, double-blind study comparing imipramine, venlafaxine, and venlafaxine plus quetiapine. Objective: It remains unclear whether unipolar psychotic depression should be treated with an antidepressant and an antipsychotic or with an antidepressant alone. Method: In a multi-center RCT, 122 patients (18–65 years) with DSM-IV-TR psychotic major depression and HAM-D-17 ≥ 18 were randomized to 7 weeks imipramine (plasma-levels 200–300 μg/l), venlafaxine (375 mg/day) or venlafaxine–quetiapine (375 mg/day, 600 mg/day). Primary outcome was response on HAM-D-17. Secondary outcomes were response on CGI and remission (HAM-D-17). Results: Venlafaxine–quetiapine was more effective than venlafaxine with no significant differences between venlafaxine–quetiapine and imipramine, or between imipramine and venlafaxine. Secondary outcomes followed the same pattern. Conclusion: That unipolar psychotic depression should be treated with a combination of an antidepressant and an antipsychotic and not with an antidepressant alone, can be considered evidence based with regard to venlafaxine–quetiapine vs. venlafaxine monotherapy. Whether this is also the case for imipramine monotherapy is likely, but cannot be concluded from the data. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/j.1600-0447.2009.01464.x
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