Olanzapine augmentation in the treatment of melancholia: the trajectory of improvement in rapid responders.

摘要

It has been suggested that the atypical antipsychotic drugs may induce a rapid improvement in individuals with melancholic depression. This might reflect a specific or non-specific effect on mood and other parameters. To examine this issue, ten consecutive patients, for whom olanzapine augmentation was judged a clinically appropriate strategy, were asked to complete daily ratings of depression severity and component features for 1 week. Of the six rapid responders, there was a 52% group improvement in the first day and 89% improvement at 1 week. Item analyses suggested the most rapid impact was evident for insomnia, compared to a slower and linear improvement in depressed mood. Such findings may assist in an understanding of the mechanisms underlying augmentation with atypical neuroleptic drugs.