Psychiatry Investig.  2020 Aug;17(8):796-803. 10.30773/pi.2020.0017.

Efficacy of Buspirone Augmentation of Escitalopram in Patients with Major Depressive Disorder with and without Atypical Features: A Randomized, 8 Week, Multicenter, Open-Label Clinical Trial

Affiliations
  • 1Department of Psychiatry, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
  • 2Department of Psychiatry, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
  • 3Department of Psychiatry, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
  • 4Department of Psychiatry, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
  • 5Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
  • 6Clinical Emotion and Cognition Research Laboratory, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea

Abstract


Objective
This study investigated the treatment response and cognitive enhancement effects of buspirone augmentation of escitalopram in patients with major depressive disorder (MDD), according to atypical feature subtypes of MDD.
Methods
An 8 week, randomized, parallel-controlled, open-label study was conducted. The Columbia Atypical Depression Diagnostic Scale was administered to evaluate atypical features. Patients were assigned randomly to the buspirone augmentation or non-buspirone groups. Symptom severity and cognitive function were evaluated using the 17-item Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Beck Depression Inventory, Beck Anxiety Inventory, digit span test, word fluency test, and Trail Making Tests A and B.
Results
A total of 89 patients were recruited. There were no significant differences in the measures between the groups; however, among the MDD patients without atypical features, the digit span and word fluency tests were improved by treatment. In the MDD patients without atypical features, the buspirone augmentation group showed a significant improvement on the digit span test compared to the non-buspirone group.
Conclusion
Buspirone augmentation did not demonstrate significant benefits in MDD patients; however, buspirone augmentation showed greater efficacy for the improvement of cognitive function in MDD patients without atypical features. Our study suggests that atypical features are an important factor for cognitive enhancement in buspirone augmentation treatment in patients with MDD.

Keyword

Atypical features, Major depressive disorder, Digit span, Buspirone, Escitalopram
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