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Pharmacopsychiatry 2012; 45(04): 152-155
DOI: 10.1055/s-0031-1297984
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Predictors of Response to Ziprasidone: Results from a 6-Week Randomized Double-Blind, Placebo-Controlled Trial for Acute Depressive Mixed State

C.-U. Pae
1   Department of Psychiatry, Duke University Medical Center, Durham, NC, USA
2   Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, South Korea
,
A. A. Patkar
1   Department of Psychiatry, Duke University Medical Center, Durham, NC, USA
,
W. Gilmer
3   Department of Psychiatry, Northwestern University, School of Medicine, Chicago, IL, USA
,
N. Holtzman
4   Mood Disorders Program, Department of Psychiatry, Tufts Medical Center, Boston, MA, USA
,
S. B. Thommi
4   Mood Disorders Program, Department of Psychiatry, Tufts Medical Center, Boston, MA, USA
,
S. N. Ghaemi
4   Mood Disorders Program, Department of Psychiatry, Tufts Medical Center, Boston, MA, USA
5   Tufts University School of Medicine, Boston, MA, USA
› Author Affiliations
Further Information

Publication History

received 26 September 2011
revised 07 November 2011

accepted 23 November 2011

Publication Date:
31 January 2012 (online)

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Abstract

Introduction:

The present study is aimed at investigating possible predictors of response to ziprasidone in a sample of patients with mixed depressive state.

Methods:

72 patients were randomized to either ziprasidone or placebo and treated prospectively for 6 weeks. The clinical response and remission were defined with various clinical variables including Montgomery Asberg Depression Rating Scale. Further outcome measures included predictors of remission and other clinical variables over time.

Results:

None of the variables under investigation were significantly associated with response or remission at 6 weeks (all p-values>0.003, respectively).

Conclusion:

Further investigations are warranted due to clear limitations, mostly small sample size and use of concomitant medications.

Key words

ziprasidone - predictor to response - mixed depressive episode - bipolar disorder - clinical trial
 

  • References

  • 1 Dilsaver SC, Benazzi F. Treating depressive mixed States in bipolar disorders. J Clin Psychiatry 2008; 69: e23
    CrossrefPubMedGoogle Scholar
  • 2 Akiskal HS, Benazzi F. Validating Kraepelin’s two types of depressive mixed states: “depression with flight of ideas” and “excited depression”. World J Biol Psychiatry 2004; 5: 107-113
    CrossrefPubMedGoogle Scholar
  • 3 Benazzi F. Major depressive episodes with hypomanic symptoms are common among depressed outpatients. Compr Psychiatry 2001; 42: 139-143
    CrossrefPubMedGoogle Scholar
  • 4 Judd LL, Akiskal HS, Schettler PJ et al The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry 2002; 59: 530-537
    CrossrefPubMedGoogle Scholar
  • 5 Benazzi F. Can only reversed vegetative symptoms define atypical depression?. Eur Arch Psychiatry Clin Neurosci 2002; 252: 288-293
    CrossrefPubMedGoogle Scholar
  • 6 Angst J, Gamma A, Benazzi F et al. Does psychomotor agitation in major depressive episodes indicate bipolarity? Evidence from the Zurich Study. Eur Arch Psychiatry Clin Neurosci 2009; 259: 55-63
    CrossrefPubMedGoogle Scholar
  • 7 Swann AC. Depression, mania, and feeling bad: the role of dysphoria in mixed states. Bipolar Disord 2000; 2: 325-327
    CrossrefPubMedGoogle Scholar
  • 8 Koukopoulos A, Koukopoulos A. Agitated depression as a mixed state and the problem of melancholia. Psychiatr Clin North Am 1999; 22: 547-564
    CrossrefPubMedGoogle Scholar
  • 9 Rihmer A, Gonda X, Balazs J et al. The importance of depressive mixed states in suicidal behaviour. Neuropsychopharmacol Hung 2008; 10: 45-49
    PubMedGoogle Scholar
  • 10 Swann AC, Gerard Moeller F, Steinberg JL et al. Manic symptoms and impulsivity during bipolar depressive episodes. Bipolar Disord 2007; 9: 206-212
    CrossrefPubMedGoogle Scholar
  • 11 Lipkovich IA, Houston JP, Ahl J. Identifying patterns in treatment response profiles in acute bipolar mania: a cluster analysis approach. BMC Psychiatry 2008; 8: 65
    CrossrefPubMedGoogle Scholar
  • 12 Patkar A, Gilmer W, Pae CU et al. A 6 week randomized double-blind placebo-controlled trial of ziprasidone for the acute depressive mixed state. PLoS ONE, in press
    PubMedGoogle Scholar
  • 13 First MB, Spitzer RL, Gibbon M et al. Structured Clinical Interview for DSM-IV Axis I Disorders – Patient Edition (SCID – I/P, Version 2.0). (New York: Biometrics Research Department, New York State Psychiatric Institute, 1995)
    PubMed
  • 14 Galinowski A, Lehert P. Structural validity of MADRS during antidepressant treatment. Int Clin Psychopharmacol 1995; 10: 157-161
    CrossrefPubMedGoogle Scholar
  • 15 Spearing MK, Post RM, Leverich GS et al. Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res 1997; 73: 159-171
    CrossrefPubMedGoogle Scholar
  • 16 Jones SH, Thornicroft G, Coffey M et al. A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). Br J Psychiatry 1995; 166: 654-659
    CrossrefPubMedGoogle Scholar
  • 17 Barnes TR. A rating scale for drug-induced akathisia. Br J Psychiatry 1989; 154: 672-676
    CrossrefPubMedGoogle Scholar
  • 18 Simpson GM, Angus JW. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl 1970; 212: 11-19
    PubMedGoogle Scholar
  • 19 StatSoft I. STATISTICA per Windows; StatSoft Italia srl 1995;
    PubMed
  • 20 Cohen J. Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates; Hillsdale, New Jersey: 1988
    Google Scholar
  • 21 Zarate Jr CA, Narendran R, Tohen M et al Clinical predictors of acute response with olanzapine in psychotic mood disorders. J Clin Psychiatry 1998; 59: 24-28
    CrossrefPubMedGoogle Scholar
  • 22 Zarate Jr CA, Rothschild A, Fletcher KE et al. Clinical predictors of acute response with quetiapine in psychotic mood disorders. J Clin Psychiatry 2000; 61: 185-189
    CrossrefPubMedGoogle Scholar
  • 23 Buckley PF, Harvey PD, Bowie CR et al. The relationship between symptomatic remission and neuropsychological improvement in schizophrenia patients switched to treatment with ziprasidone. Schizophr Res 2007; 94: 99-106
    CrossrefPubMedGoogle Scholar