MIDAS Project Publication Abstracts
Posternak, M.A., Zimmerman, M. The effectiveness of switching
antidepressants during remission: A case series of depressed patients with
intolerable side effects. Journal of Affective Disorders, in press.
Background: It is unknown whether depressed patients who have
experienced intolerable side effects to one antidepressant can safely and
effectively be switched to a second antidepressant while the depressive
disorder is in remission. The present study sought to determine the
viability of such a strategy. Methods: All subjects were
psychiatric outpatients who were treated in an open-label manner according
to standard clinical practice. From an initial cohort of approximately 200
patients with major depressive disorder, 9 had their antidepressant
switched while in remission because of intolerable side effects. Their
subsequent course was prospectively assessed at each follow-up visit using
Standardized Clinical Outcome Ratings and the Clinical Global
Impression-Improvement scale. Results: Patients were prospectively
followed for 8 to 110 weeks (median, 30 weeks) subsequent to the
initiation of the second antidepressant trial. Switching antidepressants
effectively eliminated the problematic side effects in all 9 cases. No
relapses occurred during the second antidepressant trial. Conclusion:
The present study provides preliminary evidence that switching
antidepressants while in remission may be a safe and effective strategy
for managing antidepressant-induced side effects. Limitations: Our
findings are limited by the small sample size, lack of control group, and
short follow-up periods in some cases.
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