Additional reduction of residual symptoms with aripiprazole augmentation in the patients with partially remitted major depressive disorder
Cheolmin Shin 1, Chi-Un Pae 2, 7, Kyung Phil Kwak 3, Sang Won Jeon 4, Hyun-Ghang Jeong 1, Jong-Woo Kim 5, Youn Jung Lee 6, Ashwin A. Patkar 7, Changsu Han 1*
1Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea, 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, 3Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea, 4Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea, 5Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Republic of Korea., 6Department of Psychiatry, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea, 7Department of Psychiatry and Behavioural Sciences, Duke University Medical Center, Durham, North Carolina, USA
Received: March 26, 2020; Revised: April 21, 2020; Accepted: April 27, 2020; Published online: April 27, 2020.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: Many patients with major depressive disorder (MDD) suffer from residual symptoms without achieving remission. However, pharmacologic options for residual symptoms of MDD have been limited. This study aimed to investigate benefit of aripiprazole augmentation in the treatment of residual symptoms in the patients with partially remitted MDD.
Methods: We retrospectively analyzed the 8-week medical records of the patients. The enrolled patients did respond to treatment of antidepressant but were not remitted. The range of 17–item Hamilton Depression Rating Scale (HAMD) total score of the subjects were 8 to 15 points. All patients were currently taking antidepressants when they started aripiprazole. The primary endpoint was the mean change of Clinically Useful Depression Outcome Scale (CUDOS). Secondary endpoint measures were HAMD, Clinical Global Impression–severity (CGI-S) scores, Patient Health Questionnaire–15 (PHQ-15), Beck Anxiety Inventory (BAI), Perceived Deficit Questionnaire-Depression (PDQ-D), Sheehan Disability Scale (SDS) and General Health Questionnaire/Quality of Life-12 (GHQ/QL-12).
Results: A total of 134 medical records were analyzed. The changes of CUDOS, HAMD, CGI-S, BAI, PHQ-15, PDQ-D, SDS and GHQ/QL-12 from baseline to the endpoint were -7.93, -3.29, -0.80, -4.02, -2.05, -4.35, -4.77 and -2.82, respectively (all P < 0.001). At the endpoint, the newly remitted subjects rate by HAMD score criteria were approximately 46%.
Conclusions: Our preliminary findings have presented the effectiveness of aripiprazole augmentation for residual symptoms of partially remitted MDD patients in routine practice. This study assures subsequent well-controlled studies of the possibility of generalizing the above promising outcome in the future.
Keywords: Residual symptom, Major depressive disorder, Antidepressant, Aripiprazole augmentation


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