sustaining remission of psychotic depression rationale, design and methodology of stop-pd维持缓解精神抑郁的理由,stop-pd的设计和方法.pdfVIP

Flint et al. BMC Psychiatry 2013, 13:38 /1471-244X/13/38 STUDY PROTOCOL Open Access Sustaining remission of psychotic depression: rationale, design and methodology of STOP-PD ΙΙ 1,2,3,9* 4 5 6 1,7 Alastair J Flint , Barnett S Meyers , Anthony J Rothschild , Ellen M Whyte , Benoit H Mulsant , 8 4 Matthew V Rudorfer , Patricia Marino and on behalf of the STOP-PD II Study Group Abstract Background: Psychotic depression (PD) is a severe disabling disorder with considerable morbidity and mortality. Electroconvulsive therapy and pharmacotherapy are each efficacious in the treatment of PD. Expert guidelines recommend the combination of antidepressant and antipsychotic medications in the acute pharmacologic treatment of PD. However, little is known about the continuation treatment of PD. Of particular concern, it is not known whether antipsychotic medication needs to be continued once an episode of PD responds to pharmacotherapy. This issue has profound clinical importance. On the one hand, the unnecessary continuation of antipsychotic medication exposes a patient to adverse effects, such as weight gain and metabolic disturbance. On the other hand, premature discontinuation of antipsychotic medication has the potential risk of early relapse of a severe disorder. Methods/design: The primary goal of this multicenter randomized placebo-controlled trial is to assess the risks and benefits of continuing antipsychotic medication in persons with PD once the episode of depression has responded to treatment with an antidepressant and an antipsychotic. Secondary goals are to examine age and genetic polymorphisms as predictors or mode