Help for Refractory Depression, Study

United Press International (UPI) - August 7, 2006

People whose depression does not respond to standard therapy may benefit from treatment with a psychotropic agent such as Risperidone.

That's the conclusion of a new study, which took place in 57 in- and outpatient centers in three countries, and was led by Mark Hyman Rapaport of Cedars-Sinai Hospital in Los Angeles.

The group studied 489 patients diagnosed with major depressive disorder for an average of two years who had not improved after one to three different courses of treatment with selective serotonin reuptake inhibitors (SSRIs).

All patients received Citalopram, up to 60 mg/day for four to six weeks. Those who did not have at least a 50 percent reduction in symptoms were offered unblinded supplemental treatment with up to 2 mg/day of Risperidone, a broad-spectrum atypical antipsychotic agent.

Almost 60 percent of the people who received Risperidone met the criteria for remission in four to six weeks, the researchers said. At that point, the participants entered the double-blind portion of the study and were randomized to either Risperidone or placebo.

Patients who were less severely depressed did not need additional Risperidone treatment and did well if they were given placebo. More severely depressed patients needed to take Risperidone on an ongoing basis to help their antidepressant medication work effectively.

"Treatment-resistant depression is associated with ... a severely decreased quality of life," said Rapaport. "It is one of the most pressing public health needs we face as a society. We hope this study will stimulate other researchers to pursue ... the need for continuation of supplemented therapies."