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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  ‡
1   Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
,
Venkat Bhat‡
2   Department of Psychiatry, University of Toronto, Toronto, ON, Canada
,
Peter Giacobbe
2   Department of Psychiatry, University of Toronto, Toronto, ON, Canada
,
Wendy Lou
3   Dalla Lane School of Public Health, University of Toronto, ON, Canada
,
Erin E. Michalak
1   Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
,
Trisha Chakrabarty
1   Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
,
Benicio N. Frey
4   Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
,
Roumen V. Milev
5   Departments of Psychiatry and Psychology, Queen’s University, Kingston, ON, Canada
,
Daniel J. Müller
2   Department of Psychiatry, University of Toronto, Toronto, ON, Canada
,
Sagar V. Parikh
6   Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
,
Susan Rotzinger
2   Department of Psychiatry, University of Toronto, Toronto, ON, Canada
,
Sidney H. Kennedy
2   Department of Psychiatry, University of Toronto, Toronto, ON, Canada
,
Raymond W. Lam
1   Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
,
on behalf of the CAN-BIND Investigator Team › Author Affiliations Funding: CAN-BIND is an Integrated Discovery Program carried out in partnership with and receiving financial support from the Ontario Brain Institute, an independent non-profit corporation, funded partially by the Ontario government. The opinions, results, and conclusions are those of the authors, and no endorsement by the Ontario Brain Institute is intended or should be inferred. Additional funding was provided by the Canadian Institutes of Health Research, Lundbeck, Bristol Myers Squibb, and Servier. Funding and/or in-kind support was also provided by the investigators’ academic institutions.
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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


Publication History

Received: 23 September 2020
Received: 03 February 2021

Accepted: 03 February 2021

Article published online:
02 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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