Dosing Patterns of Aripiprazole and Quetiapine for Adjunctive Treatment of Major Depressive Disorder (2006-2010).

Dosing patterns of aripiprazole and quetiapine for adjunctive treatment of major depressive disorder (2006-2010).

Filed under: Depression Treatment

Int Clin Psychopharmacol. 2012 Dec 19;
Jing Y, Guo Z, Kalsekar I, Forbes RA, Hebden T, Thase ME

The aim of this study was to investigate the dosing patterns of adjunctive quetiapine or adjunctive aripiprazole in the treatment of major depressive disorder from 2006 to 2010, and to evaluate the impact of Food and Drug Administration (FDA) approval on these dosing patterns. Patients included in the study were adults diagnosed with major depressive disorder, and treated with adjunctive aripiprazole or quetiapine between the years 2006 and 2010. The average daily dose and dose distribution were calculated and assessed statistically over the same time period. The mean daily dose for patients treated with adjunctive aripiprazole decreased from 13.5 mg/day in 2006 to 6.9 mg/day in 2010, whereas the mean daily dose for patients treated with quetiapine increased from 129 mg/day in 2006 to 139 mg/day in 2007, decreasing to 123 mg/day in 2010. The proportion of patients receiving FDA-recommended doses increased significantly for aripiprazole (86.3% in 2006 to 94.5% in 2010; P<0.001) and remained relatively stable for quetiapine (21.3% in 2006 to 24.0% in 2010; NS). The majority of patients treated with quetiapine received doses below those recommended by the FDA throughout the study period. Aripiprazole was mostly prescribed at therapeutic doses (pre-FDA and post-FDA approval), although the mean dose decreased significantly over time. %%T::11%%%%T::11%%%%T::11%%HubMed - depression treatment%%T::11%%%%T::11%%%%T::11%% %%T::11%% %%T::11%% %%T::12%%Is Pain Associated with Suicidality in Stroke?%%T::13%%%%T::14%%Filed under:%%T::15%% %%T::16%%Depression Treatment%%T::17%%%%T::18%%%%T::19%%Arch Phys Med Rehabil%%T::20%%. 2012 Dec 18; %%T::21%%Wai-Kwong T, Huajun L, Vincent M, Gabor S U, Ka-Sing W%%T::22%%OBJECTIVE: To evaluate the relationship between poststroke pain and suicidality (SI) in Chinese patients with first or recurrent stroke. DESIGN: Cross-sectional survey SETTING: Acute Stroke Unit of a university-affiliated general hospital in Hong Kong PARTICIPANTS: A total of 496 patients with acute ischemic stroke admitted to the Acute Stroke Unit. Interventions: Not applicable. MAIN OUTCOME MEASURES: Patients were interviewed 3 months after the index stroke. SI was assessed with the Geriatric Mental State Examination. Pain was evaluated with the Faces Pain Rating Scale-Revised (FPS-R). The association between FPS-R scores and SI were examined and adjusted for potential confounders, including marital status, depression, neurological deficits assessed by the National Institute of Health Stroke Scale and functioning measured by the Barthel Index. RESULTS: Thirty-seven (7.5%) of the patients had SI (SI group). Compared to the non-SI group, patients in the SI group were more likely to experience pain (59.5% vs 37.7%), had a higher mean FPS-R score (6.0+2.5 versus 4.5+2.3) and had a FPS-R score >4 (43.2% vs 15.9%). After adjustment for possible confounders, the FPS-R score >4 (odds ratio=2.9) remained a significant predictor of suicidality in the subsequent forward logistic regression models. CONCLUSIONS: These findings should alert clinicians that the early identification and treatment of pain may reduce suicide risk in stroke patients.
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