TY  - JOUR
PY  - 1998//
TI  - Short-term augmentation of fluoxetine with clonazepam in the treatment of depression: a double-blind study
JO  - American journal of psychiatry
A1  - Smith, W. T.
A1  - Londborg, P. D.
A1  - Glaudin, V.
A1  - Painter, J. R.
SP  - 1339
EP  - 1345
VL  - 155
IS  - 10
N2  - 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 "moderately ill" or "markedly ill" 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 ("much" or "very much" 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>
LA  - en
SN  - 0002-953X
UR  - http://dx.doi.org/10.1176/ajp.155.10.1339
ID  - ref1
ER  -