A Preliminary Randomized Controlled Trial of Different Treatment Regimens for Melancholic Depression

Background: Fluoxetine, bupropion, cognitive behavioral therapy (CBT), and physical therapies (modified electroconvulsive treatment or repetitive transcranial magnetic stimulation) can be used to manage melancholic depression. Objective: To compare the efficacy and safety of various treatments in pa...

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Bibliographic Details
Published in:Neuropsychiatric disease and treatment 2021-01, Vol.17, p.2441-2449
Main Authors: Wang, Yun, Liu, Xiaohua, Peng, Daihui, Wu, Yan, Su, Yun'ai, Xu, Jia, Ma, Xiancang, Li, Yi, Shi, Jianfei, Cheng, Xiaojing, Rong, Han, Fang, Yiru
Format: Article
Language:English
Subjects:
Adverse events
Angina pectoris
Antidepressants
Behavior modification
brain stimulation
Bupropion
Care and treatment
Clinical trials
Cognitive ability
Cognitive behavioral therapy
Cognitive therapy
Consciousness
Depression, Mental
Drugs
Electroconvulsive therapy
Fluoxetine
Magnetic brain stimulation
Magnetic fields
major depressive disorder
melancholic depression
Mental depression
Normal distribution
Original Research
Patients
Psychotherapy
Remission
Remission (Medicine)
Safety
Suicides & suicide attempts
Testing
Transcranial magnetic stimulation
Variables
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Summary:Background: Fluoxetine, bupropion, cognitive behavioral therapy (CBT), and physical therapies (modified electroconvulsive treatment or repetitive transcranial magnetic stimulation) can be used to manage melancholic depression. Objective: To compare the efficacy and safety of various treatments in patients with melancholic depression. Methods: This was a preliminary multicenter randomized controlled trial that included patients with depression in their first or recurrent acute episode between September 2016 and June 2019, and randomized to fluoxetine, fluoxetine+CBT, fluoxetine+bupropion, and fluoxetine+bupropion+brain stimulation. The primary endpoint was the decrease in the 17-item Hamilton Depression Rating Scale (17-HDRS). The secondary endpoint included the scores from the Quick Inventory of Depressive Symptomatology (QIDS-SR), QOL-6, and safety. Adverse events (AEs) were monitored. The follow-ups were performed at the end of the 0th, 2nd, 4th, 6th, 8th, and 12th weeks of treatment. Results: Finally, 113 patients were included in the analyses: fluoxetine (n=37), fluoxetine +CBT (n=27), fluoxetine+bupropion (n=34), and fluoxetine+bupropion+brain stimulation (n=15). The 17-HDRS and QIDS-SR scores decreased in all four groups (all P
ISSN:1178-2021
1176-6328
1178-2021
DOI:10.2147/NDT.S303938