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Original Research

Patients With Severe Depression May Benefit From Buspirone Augmentation of Selective Serotonin Reuptake Inhibitors: Results From a Placebo-Controlled, Randomized, Double-Blind, Placebo Wash-In Study

Björn G. Appelberg, Erkka K. Syvälahti, Teuvo E. Koskinen, Olli-Pekka Mehtonen, Timo T. Muhonen, and Hannu H. Naukkarinen

Published: June 1, 2001

Article Abstract

Background: Although case reports andopen studies have reported augmentation with buspirone to bebeneficial in the treatment of depression refractory to treatmentwith a selective serotonin reuptake inhibitor (SSRI), a recentlypublished randomized, placebo-controlled, double-blind studyfailed to show superiority of buspirone over placebo in thisrespect.

Method: One hundred two outpatients whofulfilled DSM-IV criteria for a major depressive episode and whohad failed to respond to a minimum of 6 weeks of treatment witheither fluoxetine or citalopram were included in thisdouble-blind, randomized, placebo-controlled study. After asingle-blind placebo wash-in period of 2 weeks while continuingtheir SSRI, the patients were randomly assigned to adjunctivetreatment with either buspirone, 10 to 30 mg b.i.d., or placebofor 6 weeks. Patients were assessed using the Montgomery-AsbergDepression Rating Scale (MADRS), the Clinical Global Impressionsscale (CGI), and visual analogue scales.

Results: After the first week of double-blindtreatment, there was a significantly greater reduction in MADRSscore (p = .034) in the buspirone group as compared with placebo.At endpoint, there was no significant difference betweentreatment groups as a whole, although patients with initiallyhigh MADRS scores (> 30) showed a significantly greaterreduction in MADRS score (p = .026) in the buspirone group ascompared with placebo.

Conclusion: Patients with severe depressivesymptoms may benefit from augmentation with buspirone. It cannotbe excluded that augmentation with buspirone may speed up theantidepressive response of patients refractory to treatment withfluoxetine or citalopram.

Volume: 62

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