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A double-blind randomized controlled trial of olanzapine plus sertraline vs olanzapine plus placebo for psychotic depression: the study of pharmacotherapy of psychotic depression (STOP-PD)
Psychiatry Publications and Presentations
  • Barnett S. Meyers, Cornell University
  • Alastair J. Flint, University of Toronto
  • Anthony J. Rothschild, University of Massachusetts Medical School
  • Benoit H. Mulsant, University of Toronto
  • Ellen M. Whyte, University of Pittsburgh
  • Catherine Peasley-Miklus, Cornell University
  • Eros Papademetriou, Weill Medical College
  • Andrew C. Leon, Weill Medical College
  • Moonseong Heo, Albert Einstein College of Medicine
  • Paul S. Appelbaum, University of Massachusetts Medical School
  • Philip J. Candilis, University of Massachusetts Medical School
  • Nancy Byatt, University of Massachusetts Medical School
  • Kristina M. Deligiannidis, University of Massachusetts Medical School
UMMS Affiliation
Department of Psychiatry
Date
8-1-2009
Document Type
Article
Medical Subject Headings
Antipsychotic Agents; Benzodiazepines; Depressive Disorder, Major; Double-Blind Method; Drug Therapy, Combination; Humans; Placebos; Psychotic Disorders; Serotonin Uptake Inhibitors; Sertraline; Treatment Outcome
Disciplines
Abstract
CONTEXT: Evidence for the efficacy of combination pharmacotherapy has been limited and without positive trials in geriatric patients with major depression (MD) with psychotic features. OBJECTIVES: To compare remission rates of MD with psychotic features in those treated with a combination of atypical antipsychotic medication plus a serotonin reuptake inhibitor with those treated with antipsychotic monotherapy; and to compare response by age. DESIGN: Twelve-week, double-blind, randomized, controlled trial. SETTING: Clinical services of 4 academic sites. Patients Two hundred fifty-nine subjects with MD with psychotic features randomized by age ( or =60 years) (mean [standard deviation (SD)], 41.3 [10.8] years in 117 younger adults vs 71.7 [7.8] years in 142 geriatric participants). Intervention Target doses of 15 to 20 mg of olanzapine per day plus masked sertraline or placebo at 150 to 200 mg per day. Main Outcome Measure Remission rates of MD with psychotic features. RESULTS: Treatment with olanzapine/sertraline was associated with higher remission rates during the trial than olanzapine/placebo (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.12-1.47; P < .001); 41.9% of subjects who underwent combination therapy were in remission at their last assessment compared with 23.9% of subjects treated with monotherapy (chi(2)(1) = 9.53, P = .002). Combination therapy was comparably superior in both younger (OR, 1.25; 95% CI, 1.05-1.50; P = .02) and older (OR, 1.34; 95% CI, 1.09-1.66; P = .01) adults. Overall, tolerability was comparable across age groups. Both age groups had significant increases in cholesterol and triglyceride concentrations, but statistically significant increases in glucose occurred only in younger adults. Younger adults gained significantly more weight than older subjects (mean [SD], 6.5 [6.6] kg vs 3.3 [4.9] kg, P = .001). CONCLUSIONS: Combination pharmacotherapy is efficacious for the treatment of MD with psychotic features. Future research must determine the benefits vs risks of continuing atypical antipsychotic medications beyond 12 weeks. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00056472.
Comments

Citation: Arch Gen Psychiatry. 2009 Aug;66(8):838-47. Link to article on publisher's site

Additional collaborators and STOP-PD Group Members from the University of Massachusetts Medical School: P. Appelbaum, MD; P. J. Candilis, MD; D. Guerin, MS; C. Wood, MS; A. Rohrbaugh, MS; S. Fratoni; C. Calkins; J. Grogan; M. Martin; J. Patel, MD; E. Smith, MD; R. Reni, MD; D. Sit, MD; E. Kayatekin, MD; D. Morin, MD; C. Cimpeanu, MD; T. Shteinlukht, MD; M. Vemuri, MD; M. Bell, MD; P. Burke, MD; N. Byatt, MD; R. Cook, MD; K. Deligiannidis, MD; I. Guryanova, MD; A. Jastiniah, MD; and A. Mathur, MD.

Related Resources
Link to Article in PubMed
PubMed ID
19652123
Citation Information
Barnett S. Meyers, Alastair J. Flint, Anthony J. Rothschild, Benoit H. Mulsant, et al.. "A double-blind randomized controlled trial of olanzapine plus sertraline vs olanzapine plus placebo for psychotic depression: the study of pharmacotherapy of psychotic depression (STOP-PD)" Vol. 66 Iss. 8 (2009) ISSN: 0003-990X (Linking)
Available at: http://works.bepress.com/philip_candilis/32/