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Olanzapine augmentation in elderly patients with treatment-resistant major depression: an open trial

Hasan Mırsal, Ayhan Kalyoncu, Özkan Pektaş, Devran Tan, Mansur Beyazyürek.

Objective: Multiple therapeutic approaches are available for the
treatment of patients who are not responding to standard
antidepressant medications. One of them is drug augmentation.
The effectiveness of olanzapine augmentation treatment for
refractory or treatment-resistant major depression in patients
over 60 years of age was studied.

Methods: An 6-week open label
study was conducted in 23 patients with recurrent major depression
without psychotic features. The refractory or treatment-resistant
depression was defined retrospectively by history of failure to
respond to antidepressants at an acceptable therapeutic doses
and duration and, patients were required to score >20 on the
17-item Hamilton Depression Rating Scale (HDRS). Subjects were
assigned to two phases of treatment; optimization with antidepressant
monotherapy at two weeks, and then augmentation with
olanzapine (10mg/day).

Results: The study subjects were 15 female
patients (65.2%), 8 male patients (34.8%). The mean age of the
study group was 65.5 years (SD=5.6). The mean HDRS score before
and after optimization was 25.6 (SD=3.1) and 25.2 (SD=5.6),
respectively. The mean HDRS score at the end of one week of
olanzapine augmentation treatment was 15.8 (SD=1.9), at the
end of 4 weeks 12.6 (SD=2.1) and at the end of 6 weeks 11.3
(SD=2.7). The differences between the means were statistically
significant (p

Key words: treatment-resistant major depression, augmentation, olanzapine, elderly people

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