Table 45Summary of included studies. Comparison 44. Switching to combined antipsychotic + SSRI versus switch to SSRI-only

StudyPopulationInterventionComparisonDetails of inadequate response/treatment resistanceComments

Corya 2006

RCT

16 countries

N=303

Mean age (years): NR

Gender (% female): NR

Ethnicity (% BME): NR

Baseline severity: NR (more severe)

Olanzapine 6 or 12mg/day + fluoxetine 25 or 50mg/dayFluoxetine 25 or 50mg/dayTRD: Inadequate response to SSRI after ≥6 weeks at a therapeutic dose at entry into the trial and inadequate response (<30% improvement in MADRS score) to 7 weeks of venlafaxine 75–375mg/day

Treatment length (weeks): 12

Outcomes:

  • Depression symptomatology change score
  • Remission
  • Response
  • Discontinuation due to any reason
  • Discontinuation due to side effects

Shelton 2005

RCT

US & Canada

N=288

Mean age (years): 42.1

Gender (% female): 70

Ethnicity (% BME): 9

Baseline severity: MADRS 28.45 (more severe)

Olanzapine 6-12mg/day + fluoxetine 25-50mg/dayFluoxetine 25-50mg/dayTRD: History of ≥1 failure to respond to SSRI after ≥4 weeks of therapy at a therapeutic dose, and failure to respond (<30% improvement on MADRS) to 7 weeks of nortriptyline 25-175mg/day

Treatment length (weeks): 8

Outcomes:

  • Depression symptomatology change score
  • Remission
  • Response
  • Discontinuation due to any reason
  • Discontinuation due to side effects

BME: black and minority ethnic; MADRS: Montgomery-Asberg depression rating scale; NR: not reported; RCT: randomised controlled trial; SSRI: selective serotonin reuptake inhibitor; TRD: treatment-resistant depression

From: Further-line treatment

Cover of Further-line treatment
Further-line treatment: Depression in adults: Evidence review D.
NICE Guideline, No. 222.
Copyright © NICE 2022.

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