Pharmacopsychiatry 2006; 39(2): 79-80
DOI: 10.1055/s-2006-931547
Letter
© Georg Thieme Verlag KG Stuttgart · New York

Augmentation with Atomoxetine in Treatment-Resistant Depression with Psychotic Features

A Case ReportM. K. Pilhatsch1 , R. Burghardt2 , K.-P. Wandinger3 , M. Bauer1 , M. Adli1
  • 1Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
  • 2Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
  • 3Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
Further Information

Publication History

Received: 7.11.2005 Revised: 23.11.2005

Accepted: 21.12.2005

Publication Date:
23 March 2006 (online)

The selective norepinephrine reuptake inhibitor atomoxetine has recently been reported to be effective as an augmenting agent in treatment-resistant depression. We report on a patient with major depression with psychotic features and a history of severe treatment-resistance who responded to a trial of atomoxetine augmentation. Various adequate and experimental treatment trials (including electroconvulsive therapy [ECT]) had previously failed to effect response. Discontinuation of atomoxetine resulted in a severe relapse. The initial treatment response was achieved once more after reapplying atomoxetine. This case report is congruent with previous articles on successful atomoxetine augmentation. In addition, this is the first report on the compatibility of this treatment strategy with psychotic symptoms accompanying major depression.

References

  • 1 Berigan T. Atomoxetine used adjunctively with selective serotonin reuptake inhibitors to treat depression.  Prim Care Companion J Clin Psychiatry. 2004;  6 93-94
  • 2 Bymaster F P, Katner J S, Nelson D L, Hemrick-Luecke S K, Threlkeld P G, Heiligenstein J H, Morin S M, Gehlert D R, Perry K W. Atomoxetine increases extracellular levels of norepinephrine and dopamine in prefrontal cortex of rat: a potential mechanism for efficacy in attention deficit/hyperactivity disorder.  Neuropsychopharmacology. 2002;  27 699-711
  • 3 Carpenter L L, Milosavljevic N, Schecter J M, Tyrka A R, Price L H. Antidepressant augmentation with open-label atomoxetine.  J Clin Psychiatry. 2005;  66 1234-1238
  • 4 Chouinard G, Annable L, Bradwejn J. An early phase II clinical trial of atomoxetine (LY139603) in the treatment of newly admitted depressed patients.  Psychopharmacology (Berl). 1984;  83 126-128
  • 5 Marneros A. Affective disorders: basic principles regarding clinical course, long-term therapeutic and prophylactic strategies.  Pharmacopsychiatry. 2004;  37 (Suppl. 2) 148-151
  • 6 Papakostas G I, Petersen T J, Burns A M, Fava M. Adjunctive atomoxetine for residual fatigue in major depressive disorder. J Psychiatr Res 2005; June 21 [Epub ahead of print]
  • 7 Stahl S M, Zhang L, Damatarca C, Grady M. Brain circuits determine destiny in depression: a novel approach to the psychopharmacology of wakefulness, fatigue, and executive dysfunction in major depressive disorder.  J Clin Psychiatry. 2003;  64 (Suppl. 14) 6-17
  • 8 Yui K, Ikemoto S, Goto K, Nishijima K, Yoshino T, Ishiguro T. Spontaneous recurrence of methamphetamine-induced paranoid-hallucinatory states in female subjects: susceptibility to psychotic states and implications for relapse of schizophrenia.  Pharmacopsychiatry. 2002;  35 62-71
  • 9 Zerbe R L, Rowe H, Enas G G, Wong D, Farid N, Lemberger L. Clinical pharmacology of tomoxetine, a potential antidepressant.  J Pharmacol Exp Ther. 1985;  232 139-143

Mazda Adli, M.D.

Department of Psychiatry and Psychotherapy

Charité - Universitätsmedizin Berlin

Campus Charité Mitte

Schumannstrasse 20-21

10117 Berlin

Germany

Phone: +49 30 450 517 146

Fax: +49 30 450 517 944

Email: mazda.adli@charite.de