Effectiveness of aripiprazole, olanzapine, quetiapine, and risperidone augmentation treatment for major depressive disorder: A nationwide population-based study

Chun Yuan Lin, Guochuan E. Tsai, Hong Song Wang, Yu Hsin Wu, Chin-Chih chih, Vivian Y. Wu, Hsien Yuan Lane

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: Previous studies suggested that antidepressants augmented with second-generation antipsychotics (SGAs), including aripiprazole, olanzapine, quetiapine, and risperidone, resulted in better treatment response or higher rates of remission in patients with major depressive disorder (MDD). However, population-based study on SGA augmentation for patients with MDD remains limited. The purpose of this study was to investigate the effectiveness of SGA augmentation for treatment of MDD using the National Health Insurance Research Database in Taiwan. Method: The subjects were patients with MDD (ICD-9- CM code: 296.2 and 296.3) who were initially admitted to psychiatric inpatient settings for the first time between January 1, 1996, and December 31, 2007, and could be tracked until December 31, 2011. To assess the treatment effect of SGA augmentation, 993 MDD patients who received aripiprazole, olanzapine, quetiapine, or risperidone augmentation treatment for 8 weeks or more were included in this 1-year mirrorimage study. Outcome measures included length of psychiatric hospitalization and number of psychiatric admissions and emergency room (ER) visits. Results: After patients received SGA augmentation treatment, key psychiatric service use (including length of psychiatric hospitalization [P < .0001], number of psychiatric admissions [P < .0001], and ER visits [P = .0006]) due to MDD diagnosis was significantly reduced. Subgrouping analysis for each SGA drug also showed significant reduction in number of psychiatric admissions for MDD patients who received aripiprazole (P < .0001), olanzapine (P = .003), quetiapine (P < .0001), and risperidone (P < .0001). Conclusions: The study provides support that aripiprazole, olanzapine, quetiapine, and risperidone augmentation therapy could be effective in reducing psychiatric service utilization among MDD patients.

Original languageEnglish
Pages (from-to)e924-e931
JournalJournal of Clinical Psychiatry
Volume75
Issue number9
DOIs
Publication statusPublished - 2014 Sep 1

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olanzapine
Risperidone
Major Depressive Disorder
Psychiatry
Antipsychotic Agents
Population
Therapeutics
Hospital Emergency Service
Hospitalization
Cohort Effect
Quetiapine Fumarate
Aripiprazole
National Health Programs
International Classification of Diseases
Taiwan
Antidepressive Agents
Inpatients

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Cite this

Lin, Chun Yuan ; Tsai, Guochuan E. ; Wang, Hong Song ; Wu, Yu Hsin ; chih, Chin-Chih ; Wu, Vivian Y. ; Lane, Hsien Yuan. / Effectiveness of aripiprazole, olanzapine, quetiapine, and risperidone augmentation treatment for major depressive disorder : A nationwide population-based study. In: Journal of Clinical Psychiatry. 2014 ; Vol. 75, No. 9. pp. e924-e931.
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abstract = "Objective: Previous studies suggested that antidepressants augmented with second-generation antipsychotics (SGAs), including aripiprazole, olanzapine, quetiapine, and risperidone, resulted in better treatment response or higher rates of remission in patients with major depressive disorder (MDD). However, population-based study on SGA augmentation for patients with MDD remains limited. The purpose of this study was to investigate the effectiveness of SGA augmentation for treatment of MDD using the National Health Insurance Research Database in Taiwan. Method: The subjects were patients with MDD (ICD-9- CM code: 296.2 and 296.3) who were initially admitted to psychiatric inpatient settings for the first time between January 1, 1996, and December 31, 2007, and could be tracked until December 31, 2011. To assess the treatment effect of SGA augmentation, 993 MDD patients who received aripiprazole, olanzapine, quetiapine, or risperidone augmentation treatment for 8 weeks or more were included in this 1-year mirrorimage study. Outcome measures included length of psychiatric hospitalization and number of psychiatric admissions and emergency room (ER) visits. Results: After patients received SGA augmentation treatment, key psychiatric service use (including length of psychiatric hospitalization [P < .0001], number of psychiatric admissions [P < .0001], and ER visits [P = .0006]) due to MDD diagnosis was significantly reduced. Subgrouping analysis for each SGA drug also showed significant reduction in number of psychiatric admissions for MDD patients who received aripiprazole (P < .0001), olanzapine (P = .003), quetiapine (P < .0001), and risperidone (P < .0001). Conclusions: The study provides support that aripiprazole, olanzapine, quetiapine, and risperidone augmentation therapy could be effective in reducing psychiatric service utilization among MDD patients.",
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Effectiveness of aripiprazole, olanzapine, quetiapine, and risperidone augmentation treatment for major depressive disorder : A nationwide population-based study. / Lin, Chun Yuan; Tsai, Guochuan E.; Wang, Hong Song; Wu, Yu Hsin; chih, Chin-Chih; Wu, Vivian Y.; Lane, Hsien Yuan.

In: Journal of Clinical Psychiatry, Vol. 75, No. 9, 01.09.2014, p. e924-e931.

Research output: Contribution to journalArticle

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T1 - Effectiveness of aripiprazole, olanzapine, quetiapine, and risperidone augmentation treatment for major depressive disorder

T2 - A nationwide population-based study

AU - Lin, Chun Yuan

AU - Tsai, Guochuan E.

AU - Wang, Hong Song

AU - Wu, Yu Hsin

AU - chih, Chin-Chih

AU - Wu, Vivian Y.

AU - Lane, Hsien Yuan

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N2 - Objective: Previous studies suggested that antidepressants augmented with second-generation antipsychotics (SGAs), including aripiprazole, olanzapine, quetiapine, and risperidone, resulted in better treatment response or higher rates of remission in patients with major depressive disorder (MDD). However, population-based study on SGA augmentation for patients with MDD remains limited. The purpose of this study was to investigate the effectiveness of SGA augmentation for treatment of MDD using the National Health Insurance Research Database in Taiwan. Method: The subjects were patients with MDD (ICD-9- CM code: 296.2 and 296.3) who were initially admitted to psychiatric inpatient settings for the first time between January 1, 1996, and December 31, 2007, and could be tracked until December 31, 2011. To assess the treatment effect of SGA augmentation, 993 MDD patients who received aripiprazole, olanzapine, quetiapine, or risperidone augmentation treatment for 8 weeks or more were included in this 1-year mirrorimage study. Outcome measures included length of psychiatric hospitalization and number of psychiatric admissions and emergency room (ER) visits. Results: After patients received SGA augmentation treatment, key psychiatric service use (including length of psychiatric hospitalization [P < .0001], number of psychiatric admissions [P < .0001], and ER visits [P = .0006]) due to MDD diagnosis was significantly reduced. Subgrouping analysis for each SGA drug also showed significant reduction in number of psychiatric admissions for MDD patients who received aripiprazole (P < .0001), olanzapine (P = .003), quetiapine (P < .0001), and risperidone (P < .0001). Conclusions: The study provides support that aripiprazole, olanzapine, quetiapine, and risperidone augmentation therapy could be effective in reducing psychiatric service utilization among MDD patients.

AB - Objective: Previous studies suggested that antidepressants augmented with second-generation antipsychotics (SGAs), including aripiprazole, olanzapine, quetiapine, and risperidone, resulted in better treatment response or higher rates of remission in patients with major depressive disorder (MDD). However, population-based study on SGA augmentation for patients with MDD remains limited. The purpose of this study was to investigate the effectiveness of SGA augmentation for treatment of MDD using the National Health Insurance Research Database in Taiwan. Method: The subjects were patients with MDD (ICD-9- CM code: 296.2 and 296.3) who were initially admitted to psychiatric inpatient settings for the first time between January 1, 1996, and December 31, 2007, and could be tracked until December 31, 2011. To assess the treatment effect of SGA augmentation, 993 MDD patients who received aripiprazole, olanzapine, quetiapine, or risperidone augmentation treatment for 8 weeks or more were included in this 1-year mirrorimage study. Outcome measures included length of psychiatric hospitalization and number of psychiatric admissions and emergency room (ER) visits. Results: After patients received SGA augmentation treatment, key psychiatric service use (including length of psychiatric hospitalization [P < .0001], number of psychiatric admissions [P < .0001], and ER visits [P = .0006]) due to MDD diagnosis was significantly reduced. Subgrouping analysis for each SGA drug also showed significant reduction in number of psychiatric admissions for MDD patients who received aripiprazole (P < .0001), olanzapine (P = .003), quetiapine (P < .0001), and risperidone (P < .0001). Conclusions: The study provides support that aripiprazole, olanzapine, quetiapine, and risperidone augmentation therapy could be effective in reducing psychiatric service utilization among MDD patients.

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