Impacts on Quality of Life with Escitalopram Monotherapy and Aripiprazole Augmentation in Patients with Major Depressive Disorder: A CAN-BIND Report

Emma Morton; Venkat Bhat; Peter Giacobbe; Wendy Lou; Erin E. Michalak; Trisha Chakrabarty; Benicio N. Frey; Roumen V. Milev; Daniel J. Müller; Sagar V. Parikh; Susan Rotzinger; Sidney H. Kennedy; Raymond W. Lam; on behalf of the CAN-BIND Investigator Team

doi:10.1055/a-1385-0263

Pharmacopsychiatry, Table of Contents

Pharmacopsychiatry 2021; 54(05): 225-231
DOI: 10.1055/a-1385-0263

Original Paper

Impacts on Quality of Life with Escitalopram Monotherapy and Aripiprazole Augmentation in Patients with Major Depressive Disorder: A CAN-BIND Report

Emma Morton ‡

¹Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

,

Venkat Bhat‡

²Department of Psychiatry, University of Toronto, Toronto, ON, Canada

,

Peter Giacobbe

²Department of Psychiatry, University of Toronto, Toronto, ON, Canada

,

Wendy Lou

³Dalla Lane School of Public Health, University of Toronto, ON, Canada

,

Erin E. Michalak

¹Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

,

Trisha Chakrabarty

¹Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

,

Benicio N. Frey

⁴Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

,

Roumen V. Milev

⁵Departments of Psychiatry and Psychology, Queen’s University, Kingston, ON, Canada

,

Daniel J. Müller

²Department of Psychiatry, University of Toronto, Toronto, ON, Canada

,

Sagar V. Parikh

⁶Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA

,

Susan Rotzinger

²Department of Psychiatry, University of Toronto, Toronto, ON, Canada

,

Sidney H. Kennedy

²Department of Psychiatry, University of Toronto, Toronto, ON, Canada

,

Raymond W. Lam

¹Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

,

on behalf of the CAN-BIND Investigator Team

› Author Affiliations

Abstract

ABSTRACT

Introduction Many individuals with major depressive disorder (MDD) do not respond to initial antidepressant monotherapy. Adjunctive aripiprazole is recommended for treatment non-response; however, the impacts on quality of life (QoL) for individuals who receive this second-line treatment strategy have not been described.

Methods We evaluated secondary QoL outcomes in patients with MDD (n=179). After 8 weeks of escitalopram, non-responders (<50% decrease in clinician-rated depression) were treated with adjunctive aripiprazole for 8 weeks (n=97); responders continued escitalopram (n=82). A repeated-measures ANOVA evaluated change in Quality of Life Enjoyment and Satisfaction Short Form scores. QoL was described relative to normative benchmarks.

Results Escitalopram responders experienced the most QoL improvements in the first treatment phase. For non-responders, QoL improved with a large effect during adjunctive aripiprazole treatment. At the endpoint, 47% of patients achieving symptomatic remission still had impaired QoL.

Discussion Individuals who were treated with adjunctive aripiprazole after non-response to escitalopram experienced improved QoL, but a substantial degree of QoL impairment persisted. Since QoL deficits may predict MDD recurrence, attention to ways to support this outcome is required.

Key words

depression - antidepressants - antipsychotics - quality of life

Full Text

References

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