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Table 4Summary of reported rates of response and remission for studies comparing monotherapy treatment to other monotherapy treatments

StudyDuration (Weeks)Rating Scalen*Comparison and Dose (mg/d)Responsea
n (%)
p ValueRemissionb
n (%)
p Value
Switch and/or Change Dose
Licht119
2002
6HAMD-NS99SER 100mg/d69 (70)0.0337 (38)0.19
98SER 200 mg/d54 (64)28 (29)
Ruhe104
2008
6HAMD-1730PAX 2010 (37.0)0.7882 (7.4)0.673
30PAX 30–5010 (33.3)4 (13.3)
Thase90
2008
8HAMD-21119VEN-ER 148mg/d45 (39.0)#NS22 (19.0)NS
113VEN-ER 309mg/d53 (49.0)#26 (24.0)
Switch to NonSSRI
Birkenhager115
2004
5HAMD-NS30TCP 61mg/d12 (40.0)^NT6 (20.0)NT
28PLZ 79mg/d14 (50.0)^2 (7.1)
Bondolfi112
2006
4MARDS19PAX 40mg/d2 (10.5)3 (15.7)
9VEN 150mg/d0 (0)0 (0)
Lenox-Smith85
2006
12HAMD-21200VEN-ER 75–300mg/dNR@0.953NRNR
206CIT 20–60mg/dNR@NR
Rush44
2006
12HAMD-17
QIDS-SR16*
238SER 50–200mg/d63 (26.7)*NS42 (17.6)
63 (26.4)*
NS
250VEN 37.5–375mg/d70 (28.2)*62 (24.8) 62 (24.8)*
239BUP 150–400mg/d62 (26.1)*51 (21.3)
61 (25.5)*
Perahia103,106
2008, 2009
10HAMD-17183direct switch DLX 60–120mg/d99 (54.4)NR65 (35.7)NR
185start-taper switch DLX 60–120mg/d109 (59.6)68 (37.2)
Add Augmenting Agent
Thase88
2007
8MADRS203FLX 50mg/dNRNR34 (16.7)0.004
197OLZ 6–18mg/dNR29 (14.7)
Shelton122
2001
8MADRS8FLX 20–60mg/d1 (10.0)0.11NRNR
8OLZ 5–20mg/d0 (0.0)NR
Ferreri121
2001
6HADRS 1738FLX 20mg/d14 (37.0)0.17 (18.p4)0.06
34MIN 60mg/d16 (48.5)12 (35.2)
Add Non-Pharmacological
Trivedi113
2006

Thase110
2007
12HAMD-17
QIDS-SR16
238SER 50–200mg/d63 (26.7)*NS42 (17.6)
63 (26.4)*
NS
250VEN 37.5–375mg/d70 (28.2)*NS62 (24.8)
62 (24.8)*
NS
239BUP 150–400mg/d62 (26.1)*NS51 (21.3)
61 (25.5)*
NS
36CBT8 (22.2)*NS9 (25.0)
11 (30.5)*
NS
86Medication23 (26.7)NS24 (27.9)
23 (26.7)*
NS

BUP = bupropion; CBT = cognitive behavioral therapy; CIT = citalopram; DLX = duloxetine; FLX = fluoxetine; HAMD = Hamilton Depression Rating Scale; HAMD-NS = Hamilton Depression Rating Scale not specified; MADRS = Montgomery-Åsberg Depression Rating Scale; MIN = mianserin; NR = not reported; NS = not significant; NT = not tested; OLZ = olanzapine; PAX = paroxetine; PLZ = phenelzine; QIDS-SR16 = Quick Inventory of Depressive Symptoms Self Report (16); SER = sertraline; SSRI = selective serotonin reuptake inhibitors; TCP = tranylcypromine; VEN = venlafaxine; VEN-ER = venlafaxine extended release

a

Response was defined as 50 percent change relative to baseline for the rating scale specified, unless noted within the table.

b

Remission was defined relative to the standard threshold value for the particular outcome.

*

The QIDS-SR reported outcomes.

#

A reduction in the HAMD score equivalent to the “decrease pretreatment”.90

^

50 percent reduction and a score of 14 on the HAMD-17.115

@

50 percent reduction on the HAMD or MADRS and CGI improvement (level 1 or 2).85

Response was defined as 50 percent change relative to baseline for the rating scale specified, unless noted within the table.

Remission was defined relative to the standard threshold value for the particular outcome.

The QIDS-SR reported outcomes.

A reduction in the HAMD score equivalent to the “decrease pretreatment”.90

50 percent reduction and a score of 14 on the HAMD-17.115

50 percent reduction on the HAMD or MADRS and CGI improvement (level 1 or 2).85

From: Results

Cover of Treatment for Depression After Unsatisfactory Response to SSRIs
Treatment for Depression After Unsatisfactory Response to SSRIs [Internet].
Comparative Effectiveness Reviews, No. 62.
Santaguida PL, MacQueen G, Keshavarz H, et al.

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