The Journal of clinical psychiatry
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Randomized Controlled Trial Multicenter Study
Extended-release quetiapine as adjunct to an antidepressant in patients with major depressive disorder: results of a randomized, placebo-controlled, double-blind study.
This 6-week, randomized, double-blind study evaluated efficacy and safety of adjunctive extended-release (XR) quetiapine in patients with major depressive disorder (MDD) and an inadequate response to >or= 1 antidepressant. ⋯ Adjunctive quetiapine XR (150 mg/day and 300 mg/day) was effective in patients with MDD who had shown an inadequate response to antidepressant treatment. Significant reduction of depressive symptoms occurred as early as week 1. Findings were consistent with the known safety and tolerability profile of quetiapine.
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Randomized Controlled Trial
McLean-Harvard International First-Episode Project: two-year stability of DSM-IV diagnoses in 500 first-episode psychotic disorder patients.
Since stability of DSM-IV diagnoses of disorders with psychotic features requires validation, we evaluated psychotic patients followed systematically in the McLean-Harvard International First Episode Project. ⋯ Bipolar I disorder and schizophrenia were more stable diagnoses than delusional disorder or MDD, severe, with psychotic features, and much more than brief psychotic disorder, psychotic disorder NOS, or schizophreniform disorder. Diagnostic changes mainly involved emergence of affective symptoms and were predicted by several premorbid factors. The findings have implications for revisions of DSM and ICD.
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Because patients with bipolar disorder spend more time experiencing depression than mania, bipolar disorder may be incorrectly diagnosed as unipolar depression. Patients presenting with depressive symptoms should be evaluated for present and lifetime mania symptomatology to ensure a correct diagnosis. Once a bipolar disorder diagnosis has been made, appropriate treatment choices, including mood stabilizers, antipsychotics, psychotherapy, and, in some cases, adjunctive antidepressants, can be made. After a patient has been stabilized, long-term treatment is necessary to prevent episode recurrence and to control subsyndromal symptoms.
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Comparative Study
An integrated analysis of olanzapine/fluoxetine combination in clinical trials of treatment-resistant depression.
To evaluate the efficacy of olanzapine/fluoxetine combination (OFC) versus olanzapine or fluoxetine monotherapy across all clinical trials of treatment-resistant depression sponsored by Eli Lilly and Company. ⋯ Results of this analysis showed that OFC-treated patients experienced significantly improved depressive symptoms compared with olanzapine- or fluoxetine-treated patients following failure of 2 or more antidepressants within the current depressive episode. Safety results for OFC were generally consistent with those for its component monotherapies. The total cholesterol increase associated with OFC was more pronounced than with olanzapine alone.