Sex Differences in Responses to Antidepressant Augmentations in Treatment-Resistant Depression.
Int J Neuropsychopharmacol
; 25(6): 479-488, 2022 06 21.
Article
em En
| MEDLINE
| ID: mdl-35167671
ABSTRACT
BACKGROUND:
Women are nearly twice as likely as men to suffer from major depressive disorder. Yet, there is a dearth of studies comparing the clinical outcomes of women and men with treatment-resistant depression (TRD) treated with similar augmentation strategies. We aimed to evaluate the effects of the augmentation strategies in women and men at the McGill University Health Center.METHODS:
We reviewed health records of 76 patients (42 women, 34 men) with TRD, treated with augmentation strategies including antidepressants (AD) with mood stabilizers (AD+MS), antipsychotics (AD+AP), or in combination (AD+AP+MS). Clinical outcomes were determined by comparing changes on the 17-item Hamilton Depression Rating Scale (HAMD-17), Montgomery-Åsberg Depression Rating Scale (MADRS), Quick Inventory of Depressive Symptomatology (QIDS-C16), and Clinical Global Impression rating scale (CGI-S) at the beginning and after 3 months of an unchanged treatment. Changes in individual items of the HAMD-17 were also compared between the groups.RESULTS:
Women and men improved from beginning to 3 months on all scales (P < .001, ηâp2 ≥ 0.68). There was also a significant sex × time interaction for all scales (P < .05, ηâp2 ≥ 0.06), reflecting a greater improvement in women compared with men. Specifically, women exhibited greater improvement in early (P = .03, ηâp2 = 0.08) and middle-of-the-night insomnia (P = .01, ηâp2 = 0.09) as well as psychomotor retardation (P < .001 ηâp2 = 0.16) and psychic (P = .02, ηâp2 = 0.07) and somatic anxiety (P = .01, ηâp2 = 0.10).CONCLUSIONS:
The combination of AD+AP/MS generates a significantly greater clinical response in women compared with men with TRD, supporting the existence of distinct pharmacological profiles between sexes in our sample. Moreover, they emphasize the benefit of augmentation strategies in women, underscoring the benefit of addressing symptoms such as insomnia and anxiety with AP and MS.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Transtorno Depressivo Maior
/
Transtorno Depressivo Resistente a Tratamento
/
Distúrbios do Início e da Manutenção do Sono
Limite:
Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article