Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA.
Int Clin Psychopharmacol. 2012 May;27(3):125-33. doi: 10.1097/YIC.0b013e3283502791.
To evaluate the efficacy of adjunctive aripiprazole in patients with minimal response to prior antidepressant therapy (ADT). Pooled data from three randomized, double-blind, placebo-controlled studies assessing the efficacy of adjunctive aripiprazole to ADT in patients with major depressive disorder who had a minimal response [< 25% reduction on the Montgomery-Åsberg Depression Rating Scale (MADRS)] to an 8-week prospective ADT. During the 6-week, double-blind adjunctive phase, response was defined as at least 50% reduction in the MADRS score and remission as at least 50% reduction in MADRS score and a MADRS score ≤ 10. Rates were examined using analysis of covariance and Cochran-Mantel-Haenszel tests. Kaplan-Meier curves were used to calculate time to response and remission. Of 1038 patients, 72% (n=746) exhibited a minimal response to ADT (ADT minimal responder). Time to response and remission were significantly shorter for ADT minimal responders receiving aripiprazole+ADT versus adjunctive placebo+ADT. ADT minimal responders on aripiprazole+ADT showed significantly greater improvements in MADRS score at endpoint compared with minimal responders on placebo+ADT (-10.3 vs. -6.5, P<0.0001). In addition, ADT minimal responders exhibited significantly higher response rates with aripiprazole+ADT than placebo+ADT (36 vs. 19%, respectively, P<0.0001) and higher remission rates (24 vs. 12%, respectively, P<0.0001). The numbers needed to treat with aripiprazole+ADT were six for response and eight for remission. Aripiprazole augmentation had a rapid and clinically meaningful effect in ADT minimal responders.
评估阿立哌唑辅助治疗先前抗抑郁治疗（ADT）反应不佳患者的疗效。对三项随机、双盲、安慰剂对照研究进行汇总分析，评估阿立哌唑辅助 ADT 治疗对先前 ADT 反应不佳（ Montgomery-Åsberg 抑郁评定量表 [MADRS] 评分降低＜25%）的重性抑郁障碍患者的疗效。在 6 周的双盲辅助阶段，以至少 MADRS 评分降低 50%为缓解定义，以至少 MADRS 评分降低 50%且 MADRS 评分≤10 为完全缓解定义。采用协方差分析和 Cochran-Mantel-Haenszel 检验评估发生率。Kaplan-Meier 曲线用于计算反应和缓解时间。在 1038 例患者中，72%（n=746）对 ADT 反应不佳（ADT 反应不佳者）。阿立哌唑+ADT 组与安慰剂+ADT 组的 ADT 反应不佳者的反应和缓解时间明显缩短。阿立哌唑+ADT 组的 ADT 反应不佳者的 MADRS 评分在终点显著高于安慰剂+ADT 组（-10.3 比-6.5，P＜0.0001）。此外，阿立哌唑+ADT 组的 ADT 反应不佳者的反应率明显高于安慰剂+ADT 组（分别为 36%和 19%，P＜0.0001），缓解率也明显高于安慰剂+ADT 组（分别为 24%和 12%，P＜0.0001）。阿立哌唑+ADT 的治疗需要数分别为 6 和 8。阿立哌唑增效对 ADT 反应不佳者有快速且具有临床意义的疗效。
