Magazine article Clinical Psychiatry News

Doubling Duloxetine Does Not Up Response Rate in Depression

Magazine article Clinical Psychiatry News

Doubling Duloxetine Does Not Up Response Rate in Depression

Article excerpt

ISTANBUL, TURKEY -- Doubling the standard 60-mg/day dose of duloxetine does not boost the response rate in patients hospitalized for severe depression.

Underscoring the drug's broad safety margin, however, the tolerability and safety of duloxetine (Cymbalta) at 120 mg/day were essentially the same as at 60 mg/day in this population, Dr. Stephan Brecht reported at the annual congress of the European College of Neuropsychopharmacology

The study involved 338 patients with severe major depressive disorder as defined by DSM-IV criteria, with or without suicidal behavior, randomized to duloxetine at 60 or 120 mg/day to test the hypothesis that the higher dose would increase response and remission rates.

The primary study end point was change in the Montgomery-Asberg Depression Rating Scale (MADRS) after 4 weeks of therapy. From a mean baseline MADRS total score of 36, the 60-mg group showed a 20.1-point decrease and the 120-mg group had a 19.9-point drop, Dr. Brecht reported.

The 4-week responder rate as defined by at least a 50% decrease in both the MADRS and the Hamilton Depression Rating Scale was 57.5% in the 60-mg group and 62% in patients on twice that dose.

Nonresponders to 4 weeks of duloxetine at 60 mg/day were switched in double-blind fashion to 120 mg/day for 4 weeks as rescue therapy. Patients initially assigned to 120 mg/day who were nonresponders after 4 weeks received a placebo while continuing on 120 mg/day for 4 more weeks. …

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