Abstract | BACKGROUND: METHOD: An 8-week open-label trial of sertraline in depressed inpatients was conducted. Twenty-five subjects had DSM-IV major depressive disorder with psychotic features, and 25 had DSM-IV major depressive disorder without psychotic features. After a 1-week open washout, all subjects were rated using the Hamilton Rating Scale for Depression (HAM-D) and Brief Psychiatric Rating Scale (BPRS) at baseline. The HAM-D was administered weekly, and the BPRS was administered again only at the end of the 8-week trial. Medication dosage was started at 50 mg/day, increased to 100 mg/day after 1 week, and then increased up to 200 mg/day if subjects had not remitted. RESULTS: Depressed patients without psychosis responded significantly better than did depressed patients with psychosis using the criteria of remission (HAM-D score - 7; p =.001), response (HAM-D score - 50% of baseline score; p =.011), referral for electroconvulsive therapy (HAM-D score >/= 15; p =.011), or change in HAM-D scores (p =.016). Baseline HAM-D score and psychosis independently predicted response, whereas baseline BPRS scores did not, regardless of whether psychotic status was entered into the analyses. CONCLUSION: Psychotic depression responds more poorly than depression without psychosis to sertraline alone. Psychosis was a predictor of response independent of degree of depression and general psychopathology. Limitations due to an open-label design are discussed, as are differences between this study and others using SSRIs for psychotic depression.
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Authors | George M Simpson, Adel El Sheshai, Ahmed Rady, Steven J Kingsbury, Mohamed Fayek |
Journal | The Journal of clinical psychiatry
(J Clin Psychiatry)
Vol. 64
Issue 8
Pg. 959-65
(Aug 2003)
ISSN: 0160-6689 [Print] United States |
PMID | 12927014
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Serotonin Uptake Inhibitors
- Sertraline
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Topics |
- Adolescent
- Adult
- Affective Disorders, Psychotic
(drug therapy, psychology)
- Aged
- Brief Psychiatric Rating Scale
- Depressive Disorder
(drug therapy, psychology)
- Female
- Hospitalization
- Humans
- Male
- Middle Aged
- Practice Guidelines as Topic
- Practice Patterns, Physicians'
- Psychiatric Status Rating Scales
- Selective Serotonin Reuptake Inhibitors
(therapeutic use)
- Sertraline
(therapeutic use)
- Sex Factors
- Treatment Outcome
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