Efficacy of aripiprazole augmentation in Japanese patients with major depressive disorder: a subgroup analysis and Montgomery-Åsberg Depression Rating Scale and Hamilton Rating Scale for Depression item analyses of the Aripiprazole Depression Multicenter Efficacy study

Psychiatry Clin Neurosci. 2015 Jan;69(1):34-42. doi: 10.1111/pcn.12214. Epub 2014 Aug 4.

Abstract

Aim: Results from this randomized, placebo-controlled study of aripiprazole augmentation to antidepressant therapy (ADT) in Japanese patients with major depressive disorder (MDD) (the Aripiprazole Depression Multicenter Efficacy [ADMIRE] study) revealed that aripiprazole augmentation was superior to ADT alone and was well tolerated. In subgroup analyses, we investigated the influence of demographic- and disease-related factors on the observed responses. We also examined how individual symptom improvement was related to overall improvement in MDD.

Methods: Data from the ADMIRE study were analyzed. Subgroup analyses were performed on the primary outcome measures: the mean change in the Montgomery-Åsberg Depression Rating Scale (MADRS) total score from the end of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) treatment to the end of the randomized treatment.

Results: Changes in the MADRS total scores were consistently greater with aripiprazole than placebo in each of the subgroups. Efficacy was not related to sex, age, number of adequate ADT trials in the current episode, MDD diagnosis, number of depressive episodes, duration of the current episode, age at first depressive episode, time since the first depressive episode, type of SSRI/SNRI, or severity at the end of SSRI/SNRI treatment phase. Compared to placebo, aripiprazole resulted in significant and rapid improvement on seven of the 10 MADRS items, including sadness.

Conclusion: These post-hoc analyses indicated that aripiprazole was effective for a variety of Japanese patients with MDD who had exhibited inadequate responses to ADT. Additionally, we suggest that aripiprazole significantly and rapidly improved the core depressive symptoms.

Trial registration: ClinicalTrials.gov NCT00876343.

Keywords: Japanese; aripiprazole; augmentation therapy; major depressive disorder; subgroup analysis.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic Uptake Inhibitors / pharmacology*
  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / pharmacology*
  • Aripiprazole
  • Depressive Disorder, Major / drug therapy*
  • Double-Blind Method
  • Drug Synergism
  • Drug Therapy, Combination
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Piperazines / administration & dosage
  • Piperazines / pharmacology*
  • Psychiatric Status Rating Scales
  • Quinolones / administration & dosage
  • Quinolones / pharmacology*
  • Selective Serotonin Reuptake Inhibitors / pharmacology*
  • Severity of Illness Index

Substances

  • Adrenergic Uptake Inhibitors
  • Antipsychotic Agents
  • Piperazines
  • Quinolones
  • Serotonin Uptake Inhibitors
  • Aripiprazole

Associated data

  • ClinicalTrials.gov/NCT00876343