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Br J Psychiatry. 1995 Jan;166(1):80-6.

Placebo-controlled trial of lithium augmentation of fluoxetine and lofepramine.

Author information

  • 1Department of Psychiatry, University College London Medical School.

Erratum in

  • Br J Psychiatry 1995 Apr;166(4):544.

Abstract

BACKGROUND:

This study was designed to establish whether (as suggested in a number of open and relatively small controlled trials) lithium augmentation is more effective than continued antidepressant alone, where response to a standard course of antidepressant treatment has been absent or partial.

METHOD:

Lithium or placebo was added on a double-blind basis for six weeks to the drug regime of 62 patients with major depressive illness (in both hospital and primary care settings) who had failed to respond to a controlled trial of fluoxetine or lofepramine. Response was defined as a final Hamilton Depression Rating Scale (HDRS) score of < 10.

RESULTS:

Response was seen more frequently in patients taking lithium (15/29) than in those remaining on antidepressant alone (8/32; P < 0.05). Rapid response to lithium augmentation (LA) was not consistently observed in this cohort. Mean HDRS scores after six weeks were significantly lower (P < 0.01) in the lithium group after excluding those who had not achieved significant exposure to lithium (arbitrarily defined as two or more lithium levels > or = 0.4 mmol/l). No differences in the efficacy of LA were apparent between fluoxetine and lofepramine.

CONCLUSIONS:

Our results confirm that LA is a useful strategy in the treatment of antidepressant-resistant depression. Partial response was, however, frequently observed with continued antidepressant treatment alone, and the superiority of LA appears to depend on achieving adequate serum lithium levels.

Comment in

  • Lithium augmentation. [Br J Psychiatry. 1995]
PMID:
7894881
[PubMed - indexed for MEDLINE]
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