An open pilot study of zonisamide augmentation in major depressive patients not responding to a low dose trial with duloxetine: Preliminary results on tolerability and clinical effects

Michele Fornaro, Matteo Martino, Bruna Dalmasso, Salvatore Colicchio, Marzia Benvenuti, Giulio Rocchi, Andrea Escelsior, Giulio Perugi

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Despite multiple antidepressant options, major depressive disorder (MDD) still faces high non-response rates, eventually requiring anticonvulsant augmentation strategies too. The aim of this study was to explore such a potential role for zonisamide.Methods: A total of 40 MDD outpatients diagnosed using the Diagnostic and Statistical Manual for Mental Disorders, fourth edition criteria entered a 24 week open trial receiving duloxetine 60 mg/day for the first 12 weeks and subsequently (weeks 12 to 24) augmentation with zonisamide 75 mg/day if they did not respond to the initial monotherapy. Efficacy and tolerability were assessed using the Hamilton Scales for Anxiety and Depression (a 12 week score ≥50% vs baseline defined 'non-response'), the Arizona Sexual Experience Scale, the Patient Rated Inventory of Side Effects and the Young Mania Rating Scale.Results: At week 12, 15 patients out of 39 (38.5%) were responders, and 1 had dropped out; remarkably, 14 patients out of 24 (58.3%) had achieved response by week 24. Poor concentration and general malaise were associated with non-response both at week 12 and 24 (P = 0.001), while loss of libido and reduced energy were prominent among final timepoint non-responders. Patients receiving zonisamide also experienced weight reduction (2.09 ± 12.14 kg; P = 0.001) independently of the outcome.Conclusions: Although only a preliminary study due to strong methodological limitations, and thus requiring confirmation by further controlled investigations, the current results indicate zonisamide may be a potential augmentation option for some depressed patients receiving low doses of duloxetine.

Original languageEnglish
Article number23
JournalAnnals of General Psychiatry
Volume10
DOIs
Publication statusPublished - Sep 19 2011
Externally publishedYes

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zonisamide
Major Depressive Disorder
Libido
Bipolar Disorder
Diagnostic and Statistical Manual of Mental Disorders
Anticonvulsants
Antidepressive Agents
Weight Loss
Outpatients
Anxiety
Duloxetine Hydrochloride
Depression
Equipment and Supplies

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

An open pilot study of zonisamide augmentation in major depressive patients not responding to a low dose trial with duloxetine : Preliminary results on tolerability and clinical effects. / Fornaro, Michele; Martino, Matteo; Dalmasso, Bruna; Colicchio, Salvatore; Benvenuti, Marzia; Rocchi, Giulio; Escelsior, Andrea; Perugi, Giulio.

In: Annals of General Psychiatry, Vol. 10, 23, 19.09.2011.

Research output: Contribution to journalArticle

Fornaro, Michele ; Martino, Matteo ; Dalmasso, Bruna ; Colicchio, Salvatore ; Benvenuti, Marzia ; Rocchi, Giulio ; Escelsior, Andrea ; Perugi, Giulio. / An open pilot study of zonisamide augmentation in major depressive patients not responding to a low dose trial with duloxetine : Preliminary results on tolerability and clinical effects. In: Annals of General Psychiatry. 2011 ; Vol. 10.
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