@article{ref1,
title="Short-term augmentation of fluoxetine with clonazepam in the treatment of depression: a double-blind study",
journal="American journal of psychiatry",
year="1998",
author="Smith, W. T. and Londborg, P. D. and Glaudin, V. and Painter, J. R.",
volume="155",
number="10",
pages="1339-1345",
abstract="OBJECTIVE: Because selective serotonin reuptake inhibitors (SSRIs) require 2-4 weeks to reach efficacy, the authors determined whether clonazepam augmentation of fluoxetine is superior to fluoxetine alone at the beginning of treatment for major depression. METHOD: Eighty adult outpatients with major depression who were rated as &quot;moderately ill&quot; or &quot;markedly ill&quot; on the Clinical Global Impression of Severity underwent 8 weeks of double-blind, randomized treatment with fluoxetine, 20 mg/day for all patients initially and 40 mg/day if needed after 6 weeks. One-half of these patients received clonazepam, 0.5 mg h.s. adjusted to two tablets by day 10 if needed, and the remainder received placebo, likewise adjusted. Clonazepam/placebo was gradually discontinued during days 21-33. Efficacy was evaluated by means of the Hamilton Depression Rating Scale, the Clinical Global Impression of Improvement, and a patient rating of global improvement. RESULTS: The patients taking clonazepam improved significantly more during the first 3 weeks of treatment according to ratings on the Hamilton scale (> or =50% improvement) and the clinician- and patient-rated global improvement measures (&quot;much&quot; or &quot;very much&quot; improved). Analysis of variance confirmed a significant effect of clonazepam for average Hamilton depression scores. No serious adverse events were found in either treatment group. Taper effects appeared modest and transitory. CONCLUSIONS: Clonazepam augmentation of fluoxetine was superior to fluoxetine alone in the first 3 weeks of treatment. This strategy may reduce suffering during early SSRI treatment, may partially suppress SSRI side effects, may increase compliance, and could possibly reduce the risk of suicide.<p /><p>Language: en</p>",
language="en",
issn="0002-953X",
doi="10.1176/ajp.155.10.1339",
url="http://dx.doi.org/10.1176/ajp.155.10.1339"
}