Augmentation With Open-Label Atomoxetine for Partial or Nonresponse to Antidepressants
J Clin Psychiatry 2005;66(10):1234-1238
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Atomoxetine is a selective
norepinephrine reuptake inhibitor currently
approved for the treatment of
attention-deficit/hyperactivity disorder. Other compounds that enhance
synaptic norepinephrine have shown efficacy as
antidepressant monotherapies and as augmentation agents. This case series study examined the
role of atomoxetine in antidepressant augmentation.
Method: Fifteen adult outpatients with
primary DSM-IV Axis I depressive disorders received open-label atomoxetine augmentation
following partial response or nonresponse to at
least 8 weeks of standard antidepressant pharmacotherapy. Atomoxetine 40 mg/day was added
to ongoing medication regimens and titrated according to clinical response. Atomoxetine was
systematically offered to patients from July through
Results: Eleven patients (73%) completed
at least 6 weeks of atomoxetine augmentation. Mean endpoint dose was approximately 80
mg/day. Nine patients (60%) met criteria for positive
categorical response. Inventory of Depressive Symptomatology-Self-Report scores decreased
significantly from baseline to endpoint, and
clinician ratings of social and occupational
functioning increased. There were no significant changes
in heart rate or blood pressure, and the most common side effect was activation. A modest but
significant drop in body mass index was observed (p = .025), and a subset (6/15; 40%) of
patients reported improved sexual function.
Conclusion: More studies are warranted
to evaluate the potential utility of atomoxetine
for antidepressant augmentation.