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Table 19Pooled rates of remission and response for atypical antipsychotic augmentation compared with antidepressant monotherapy

Atypical antipsychotic (AAP)
Sample size
Response rate
% patients, AAP vs. AD monotherapy
Relative risk (95% CI)
Remission
% patients, AAP vs. AD monotherapy
Relative risk (95% CI)
History of inadequate response
 Adjunctive
  Aripiprazole (N=1065)432, 433, 43937% vs. 22%a
RR 1.66 (1.37 to 2.01)
29% vs. 16%c
RR 1.77 (1.40 to 2.23)
  Olanzapine (N=984)434, 444–44639% vs. 29%a
RR 1.25 (0.99 to 1.58)
26% vs. 16%d,e
RR 1.54 (1.16 to 2.04)
  Quetiapine XR 300 mg (N=610)430, 43158% vs. 46%a
RR 1.26 (1.08 to 1.47)
36% vs. 24%f
RR 1.51 (1.15 to 2.00)
  Quetiapine XR 150 mg (N=612)430, 43154% vs. 46 a
RR 1.16 (0.99 to 1.36)
36% vs. 24%f
RR 1.47 (1.15 to 1.89)
  Quetiapine IR (N=58)44048% vs. 28%b
RR 1.71 (1.05 to 2.80)
31% vs. 17%g
RR 1.82 (0.92 to 3.62)
  Risperidone (N=313)437, 43849% vs. 30%a,b
RR 1.59 (1.19 to 2.14)
34% vs. 14%e,g
RR 2.21 (1.41 to 3.47)
  Ziprasidone 80 mg (N=41)43519% vs. 10%a
RR 1.90 (0.46 to 8.31)
5% vs. 5%e
RR 0.95 (0.10 to 8.78)
  Ziprasidone 160 mg (N=39)43532% vs. 10%a
RR 3.16 (0.84 to 12.71)
21% vs. 5%e
RR 4.21 (0.71 to 26.85)
No history of inadequate response
 Monotherapy
  Quetiapine XR 300 mg (N=1260)448, 449, 453, 45455% vs. 41%a
RR 1.33 (1.18 to 1.49)
32% vs. 24%f
1.29 (1.06 to 1.58)
  Quetiapine XR 150 mg (N=646)453, 45453% vs. 33%a
RR 1.59 (1.32 to 1.91)
23% vs. 19%f
RR 1.21 (0.90 to 1.63)

Abbreviations: AAP, atypical antipsychotic; AD, antidepressant; IR, immediate release; mg, milligrams; pts, patients; RR, relative risk; XR, extended release.

a

≥ 50% decrease in MADRS.

b

≥ 50% decrease in HAM-D.

c

≥ 50% decrease in MADRS, plus total score ≤ 10

d

2 consecutive MADRS Total Scores ≤ 8.

e

MADRS ≤ 10.

f

MADRS ≤ 8.

g

HAM-D ≤ 7.

≥ 50% decrease in MADRS.

≥ 50% decrease in HAM-D.

≥ 50% decrease in MADRS, plus total score ≤ 10

2 consecutive MADRS Total Scores ≤ 8.

MADRS ≤ 10.

MADRS ≤ 8.

HAM-D ≤ 7.

From: Results

Cover of Drug Class Review: Atypical Antipsychotic Drugs
Drug Class Review: Atypical Antipsychotic Drugs: Final Update 3 Report [Internet].
McDonagh M, Peterson K, Carson S, et al.
Portland (OR): Oregon Health & Science University; 2010 Jul.
Copyright © 2010 by Oregon Health & Science University, Portland, Oregon 97239. All rights reserved.

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