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Titolo:
The treatment of chronic depression, part 1: Study design and rationale for evaluating the comparative efficacy of sertraline and imipramine as acute, crossover, continuation, and maintenance phase therapies
Autore:
Rush, AJ; Koran, LM; Keller, MB; Markowitz, JC; Harrison, WM; Miceli, RJ; Fawcett, JA; Gelenberg, AJ; Hirschfeld, RMA; Klein, DN; Kocsis, JH; McCullough, JP; Schatzberg, AF; Thase, ME;
Indirizzi:
Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX 75235 USA Univ Texas Dallas TX USA 75235 d Ctr, Dept Psychiat, Dallas, TX 75235 USA Stanford Univ, Sch Med, Dept Psychiat, Stanford, CA 94305 USA Stanford Univ Stanford CA USA 94305 Dept Psychiat, Stanford, CA 94305 USA BrownUSAiv, Butler Hosp, Dept Psychiat & Human Behav, Providence, RI 02912Brown Univ Providence RI USA 02912 at & Human Behav, Providence, RI 02912 Cornell Univ, Coll Med, Dept Psychiat, New York, NY USA Cornell Univ New York NY USA , Coll Med, Dept Psychiat, New York, NY USA Pfizer Inc, New York, NY USA Pfizer Inc New York NY USAPfizer Inc, New York, NY USA Rush Presbyterian St Lukes Med Ctr, Dept Psychiat, Chicago, IL 60612 USA Rush Presbyterian St Lukes Med Ctr Chicago IL USA 60612 ago, IL 60612 USA Univ Arizona, Dept Psychiat, Tucson, AZ USA Univ Arizona Tucson AZ USAUniv Arizona, Dept Psychiat, Tucson, AZ USA Univ Texas, Med Branch, Dept Psychiat & Behav Sci, Galveston, TX 77550 USAUniv Texas Galveston TX USA 77550 at & Behav Sci, Galveston, TX 77550 USA SUNY Stony Brook, Dept Psychiat, Stony Brook, NY 11794 USA SUNY Stony Brook Stony Brook NY USA 11794 hiat, Stony Brook, NY 11794 USA Virginia23298onwealth Univ, Med Coll Virginia, Dept Psychiat, Richmond, VAVirginia Commonwealth Univ Richmond VA USA 23298 t Psychiat, Richmond, VA Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Pittsburgh, PA USAUniv Pittsburgh Pittsburgh PA USA ychiat Inst & Clin, Pittsburgh, PA USA
Titolo Testata:
JOURNAL OF CLINICAL PSYCHIATRY
fascicolo: 11, volume: 59, anno: 1998,
pagine: 589 - 597
SICI:
0160-6689(199811)59:11<589:TTOCDP>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
STRUCTURED CLINICAL INTERVIEW; PROSPECTIVE FOLLOW-UP; LONG-TERM EFFICACY; MAJOR DEPRESSION; TRICYCLIC ANTIDEPRESSANTS; RECURRENT DEPRESSION; ATYPICAL DEPRESSION; AFFECTIVE-DISORDERS; DYSTHYMIC DISORDER; LITHIUM-CARBONATE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
92
Recensione:
Indirizzi per estratti:
Indirizzo: Rush, AJ Univ235xas, SW Med Ctr, Dept Psychiat, 5323 Harry Hines Blvd, Dallas, TX 75 Univ Texas 5323 Harry Hines Blvd Dallas TX USA 75235 allas, TX 75
Citazione:
A.J. Rush et al., "The treatment of chronic depression, part 1: Study design and rationale for evaluating the comparative efficacy of sertraline and imipramine as acute, crossover, continuation, and maintenance phase therapies", J CLIN PSY, 59(11), 1998, pp. 589-597

Abstract

Background: Chronic depressions are common, disabling, and undertreated, and prior chronicity predicts future chronicity. However, few studies directly inform the acute or maintenance phase treatments of chronic depressions and even less is known about the effects of treatment on psychosocial functioning. Method: We describe the design and rationale for 2 parallel double-blind, randomized, multicenter acute and maintenance phase treatment trials. One focused on DSM-III-R major depression currently in a chronic (2 2 years) major depressive episode, the other on DSM-III-R major depression with concurrent DSM-III-R dysthymia ("double depression"). Results: Considering the critical knowledge deficits, we designed a 12-week acute phase safety and efficacy trial of sertraline versus imipramine, followed by a 16-week continuation treatment phase for subjects with a satisfactory therapeutic response. Patients receiving sertraline who successfullycompleted the continuation phase entered a 76-week maintenance trial to compare sertraline with placebo; those taking imipramine continued without a placebo substitution. As part of the acute trial, subjects completing but failing to respond to the initial 12-week acute phase medication were crossed over (double-blind) to the alternative medication for a 12-week acute phase trial. We obtained naturalistic follow-up data (up to 18 months) for subjects exiting the protocol at any time. Conclusion: Multiphase protocols for chronic depression can test efficacy by randomized contrasts as well as shed light on key clinical issues such as the degree of response or attrition expected at particular times in a trial or the preferred medication sequence in a potential multistep treatment program.

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Documento generato il 01/04/20 alle ore 17:49:23