D. Cesneková, E. Šnircová, G. Nosáľová and I. Ondrejka
Attention-Deficit/Hyperactivity Disorder (ADHD) is connected with high level of psychiatric comorbidity in paediatric population. Depressive disorder is common comorbid disorder co-existing with ADHD. Atomoxetine is worldwide approved for treatment of ADHD in paediatric population; in addition atomoxetine is effective and safe in treatment of some comorbid disorders in ADHD. Pharmacotherapy of depression is limited and residual symptoms are common. Fluoxetine is currently considered to be the gold standard of treatment of depression, but effectiveness of acute phase of treatment is not sufficient. Atomoxetine as a selective noradrenaline reuptake inhibitor or olanzapine as a multi receptors antagonist drug in combination with fluoxetine could be perspective augmented treatment strategy of depression just for their antidepressant effect. The aim of our following study is to evaluate and compare effectiveness and safety of monotherapy and combined/augmented therapy in acute phase of depression treatment in adolescence, as well as introduce complex modern research methodology of effectiveness and safety of treatment.
D. Cesneková, I. Ondrejka, M. Oppa, I. Tonhajzerová and G. Nosáľová
Depressive disorder is one of the most common and serious psychiatric diagnosis in paediatric population, often connected with suicidal risk. In recent years, fluoxetine monotherapy is the gold standard in acute phase of depression treatment in children and adolescents, but is not effective enough after an acute phase of treatment. More helpful researches concerning more effective therapeutic strategies of depression in this age are insufficient. The aim of our study is to evaluate the effectiveness and safety of fluoxetine monotherapy in comparison with combined olanzapine/fluoxetine therapy in acute 6-week treatment of depression in adolescence. We found that combined therapeutic strategy, using olanzapine augmentation is predicted to be more useful in the treatment of adolescent depression.
M. Oppa, I. Ondrejka, D. Cesnekova, I. Tonhajzerova and G. Nosalova
Vortioxetine is a novel antidepressant with two mechanisms of action – direct effect on several serotonin receptors and serotonin reuptake inhibition. Atypical antipsychotics, such as olanzapine, used in the augmentation of antidepressants causes not only a better response to treatment, but also increased number of remissions. The aim of our work was to evaluate the efficacy of vortioxetine monotherapy compared to the combined treatment vortioxetine and olanzapine in adult patients with depression during the acute phase of treatment lasting 6 weeks. Depressive symptomatology was assessed by the MADRS scale, anxiety symptoms were assessed by the HAM-A scale and global clinical impression were evaluated by the CGI-S scale. The number of patients in full-analysis set was 28. The results showed statistically significant improvement in CGI-S for both groups. Patients with vortioxetine monotherapy showed significant improvement in MADRS total score from the third week of treatment (p = 0.009) compared to patients with combined therapy that showed significant improvement since the end of first week of treatment (p = 0.036). Both groups showed significant improvement in HAM-A total score from the second week of treatment. Our results show the possibility of olanzapine in the augmentation strategy in treatment of major depressive disorder in adult patients.