The effects of aripiprazole on the subscales of the Kellner Symptom Questionnaire
in treatment resistant depression.
Author(s): Dording C(1), Cassiello C, King F 4th, Pencina M, Fava M, Mischoulon D.
Affiliation(s): Author information:
(1)Department of Psychiatry, Depression Clinical and Research Program, Massachusetts
General Hospital, Boston, Massachusetts, USA. cdording@partners.org
Publication date & source: 2013, Int Clin Psychopharmacol. , 28(5):238-44
We have recently examined the efficacy of low-dose aripiprazole augmentation for
major depressive disorder (MDD), with modest nonsignificant benefit found. In a
secondary investigation, we examined whether aripiprazole resulted in improvement
in four subscales (depression, anxiety, somatic symptoms, and hostility) of the
Kellner Symptom Questionnaire (KSQ). We reanalyzed data from the main outcome
study on 221 MDD patients with inadequate response to selective serotonin
reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. Patients
were randomized, using the sequential parallel comparison design, into two 30-day
phases, as follows: drug/drug (aripiprazole 2 mg/day in phase 1, aripiprazole 5
mg/day in phase 2), placebo/drug (placebo in phase 1, aripiprazole 2 mg/day in
phase 2), or placebo/placebo (placebo in both phases). We examined changes in the
KSQ score from baseline to endpoint on the basis of the subscaled Well-being and
Reversal Distressed Anxiety Subscales. The score for the KSQ depression subscale
improved from baseline to the end of follow-up, with a significant advantage for
aripiprazole over placebo (P=0.0327). Although improvement was also observed in
the anxiety and hostility scales, neither attained a significant advantage over
placebo; no significant change was observed for the somatization subscale.
Aripiprazole augmentation resulted in a significant improvement compared with
placebo augmentation only in the depression subscale of the KSQ; however, the low
dose may not have been enough to have an impact on the anxiety and hostility
scales. The good tolerability of the low dose may have resulted in the absence of
worsening of somatic symptoms. Prospective studies are needed to better
characterize the impact of low doses of aripiprazole augmentation on different
manifestations of MDD.
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