TY  - JOUR
PY  - 2009//
TI  - Factors associated with concomitant psychotropic drug use in the treatment of major depression: a STAR*D Report
JO  - CNS spectrums
A1  - Shelton, Rchard C.
A1  - Hollon, S. D.
A1  - Wisniewski, Stephen R.
A1  - Alpert, Jonathan E.
A1  - Balasubramani, G. K.
A1  - Friedman, Edward S.
A1  - Rush, A. John
A1  - Trivedi, Madhukar H.
A1  - Preskorn, Sheldon H.
SP  - 487
EP  - 498
VL  - 14
IS  - 9
N2  - INTRODUCTION: Concomitant psychotropic medication (CPM) treatment is common in persons with major depression (MDD). However, relationships with patient characteristics and response to treatment are unclear. METHODS: Participants with nonpsychotic MDD (N=2682) were treated with citalopram, 20-60 mg/day. Sociodemographic, clinical, and treatment outcome characteristics were compared between those using CPMs at study entry or during up to 14 weeks of citalopram treatment, and non-users. RESULTS: About 35% of participants used a CPM. Insomnia was the predominant indication (70.3%). CPM users were more likely to be seen in primary care settings (69.3% versus 30.7%), be white, of non-Hispanic ethnicity, married, and have a higher income, private insurance, and certain comorbid disorders. CPM users had greater depressive severity, poorer physical and mental functioning, and poorer quality of life than non-users. Response and remission rates were also lower. CPM users were more likely to achieve >50 mg/day of citalopram, to report greater side effect intensity, and to have serious adverse events, but less likely to be intolerant of citalopram. CONCLUSION: CPMs are associated with greater illness burden, more Axis I comorbidities (especially anxiety disorders), and lower treatment effectiveness. This suggests that CPM use may identify a more difficult to treat population that needs more aggressive treatment.<p />  <p>Language: en</p>
LA  - en
SN  - 1092-8529
UR  - http://dx.doi.org/
ID  - ref1
ER  -