Olanzapine and fluoxetine combination therapy for treatment-resistant depression: review of efficacy, safety, and study design issues

Treatment-resistant depression (TRD) is a common occurrence in clinical practice. Up to 30% of patients with major depression do not respond to conventional antidepressant treatment, while a significantly greater number of patients experience only partial symptom reduction. Numerous strategies may be applied by the practicing clinician to overcome limitations in the effectiveness of antidepressant monotherapy, including combining drug treatment with evidence-supported psychotherapies, combining antidepressants (combination pharmacotherapy), and combining antidepressants with other non-antidepressant psychotropic medications (augmentation treatment). One such augmentation strategy, the combination of the selective serotonin reuptake inhibitor, fluoxetine (FLX), with the atypical antipsychotic drug, olanzapine (OLZ), is supported by the results of four randomized, double-blind, acute phase studies of patients who had responded inadequately to antidepressant monotherapy. In each study, the FLX/OLZ combination caused rapid reduction in Montgomery-Asberg Depression Rating scale scores, with two of the four studies showing significantly greater improvement than antidepressant monotherapy at study endpoint. Effects of the FLX/OLZ combination were strongest in cases where failure to respond to two antidepressants prior to randomization was established during the current depressive episode. The FLX/OLZ combination was well-tolerated; however, body weight gain and increases in prolactin were greater than that of the antidepressant monotherapy groups, and were comparable to that of OLZ monotherapy. While effective during acute-phase treatment, questions remain regarding the long-term efficacy and safety of FLX/OLZ relative to antidepressant monotherapy and other combination strategies. Efforts aimed at determining the placement of FLX/OLZ among the available options for addressing TRD are limited by lack of comparison and sequential treatment studies. Important aspects of study design and directions for future research are discussed

Concert recording 2016-04-07

[Track 01]. English horn concerto / Vincent Persichetti -- [Track 02]. Divertissement / Euguene Bozza -- [Track 03]. Parable XV / Vincent Persichetti -- [Track 04]. Sonate / Paul Hindemith -- [Track 05]. Bassango / Mathieu Lussier -- [Track 06]. Blue rondo a la turk / Dave Brubek ; arranged by Richard Bobo

Concert recording 2014-02-10

[Track 01]. Sonata in G minor, H 542.5. Allegro / C.P.E. Bach -- [Track 02]. Sonata in G minor, H 542.5. Adagio / C.P.E. Bach -- [Track 03]. Sonata in G minor, H 542.5. Allegro / C.P.E. Bach ; J. Brahms -- [Track 04]. Cantata 21. Seufzer, tranen, kummer, not / J.S. Bach -- [Track 05]. Miniatures. I ride an old paint (U.S.A.) / William Grant Still -- [Track 06]. Miniatures. Adolorido (Mexico) / William Grant Still -- [Track 07]. Miniatures. Jesus is a rock in the weary land (U.S.A.) / William Grant Still -- [Track 08]. Miniatures. Yaravi (Peru) / William Grant Still -- [Track 09]. Miniatures. A frog went a-courtin\u27 (U.S.A.) / William Grant Still -- [Track 10]. Rue burq / Theresa Delaplain -- [Track 11]. Dream gardens / Robert Mueller -- [Track 12]. Sonata in C, op. 100. Con moto / Edmund Rubbra -- [Track 13]. Sonata in C, op. 100. Elegy lento / Edmund Rubbra -- [Track 14]. Sonata in C, op. 100. Presto / Edmund Rubbra -- [Track 15]. Czardas / Vittorio Monti ; arranged by Reift

Concert recording 2013-04-11

[Track 01]. Der Hirt auf dem Felsen, D. 965 / Franz Schubert -- [Track 02]. Duos for flute and clarinet, op. 34. I. Andante sostenuto ; [Track 03]. II. Allegro risoluto ; [Track 04]. III. Moderato ; [Track 05]. IV. Allegro ma non troppo ; [Track 06]. V. Andante molto ; [Track 07]. VI. Allegro / Robert Muczynski -- [Track 08]. Concert piece no. 2 in D minor, op. 114. I. Allegro con fuoco ; [Track 09]. II. Andante ; [Track 10]. III. Presto / Felix Mendelssohn -- [Track 11]. Quintet for clarinet and strings in A Major, K. 581. I. Allegro ; [Track 12]. II. Larghetto ; [Track 13]. III. Menuetto ; [Track 14]. Allegro con variazioni / W.A. Mozart

Positive predictive value of automated database records for diabetic ketoacidosis (DKA) in children and youth exposed to antipsychotic drugs or control medications: a tennessee medicaid study

<p>Abstract</p> <p>Background</p> <p>Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of treatment with some atypical antipsychotic drugs in children and <b>youth</b>. Because drug-associated DKA is rare, large automated health outcomes databases may be a valuable data source for conducting pharmacoepidemiologic studies of DKA associated with exposure to individual antipsychotic drugs. However, no validated computer case definition of DKA exists. We sought to assess the positive predictive value (PPV) of a computer case definition to detect incident cases of DKA, using automated records of Tennessee Medicaid as the data source and medical record confirmation as a "gold standard."</p> <p>Methods</p> <p>The computer case definition of DKA was developed from a retrospective cohort study of antipsychotic-related type 2 diabetes mellitus (1996-2007) in Tennessee Medicaid enrollees, aged 6-24 years. Thirty potential cases with any DKA diagnosis (ICD-9 250.1, ICD-10 E1x.1) were identified from inpatient encounter claims. Medical records were reviewed to determine if they met the clinical definition of DKA.</p> <p>Results</p> <p>Of 30 potential cases, 27 (90%) were successfully abstracted and adjudicated. Of these, 24 cases were confirmed by medical record review (PPV 88.9%, 95% CI 71.9 to 96.1%). Three non-confirmed cases presented acutely with severe hyperglycemia, but had no evidence of acidosis.</p> <p>Conclusions</p> <p>Diabetic ketoacidosis in children and youth can be identified in a computerized Medicaid database using our case definition, which could be useful for automated database studies in which drug-associated DKA is the outcome of interest.</p

Patterns of changes in bipolar depressive symptoms revealed by trajectory analysis among 482 patients with bipolar disorder

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149731/1/bdi12715_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149731/2/bdi12715.pd

Concert recording 2013-03-28

[Track 01]. Fanfares liturgiques. Procession du Vendredi-Saint / Henri Tomasi -- [Track 02]. The good soldier Schweik suite. Overture / Robert Kurka -- [Track 03]. The good soldier Schweik suite. Lament / Robert Kurka -- [Track 04]. The good soldier Schweik suite. March / Robert Kurka -- [Track 05]. The good soldier Schweik suite. War Dance / Robert Kurka -- [Track 06]. The good soldier Schweik suite. Pastoral / Robert Kurka -- [Track 07]. The good soldier Schweik suite. Finale / Robert Kurka -- [Track 08]. Serenade no. 11 in E flat major, KV 375. Allegro maestoso / Wolfgang Amadeus Mozart -- [Track 09]. Prelude, fugue and riffs / Leonard Bernstein