Adding Ziprasidone to an Antidepressant for Major Depression

Although several atypical antipsychotics are effective augmenting agents for patients with major depression who do not respond to serotonin reuptake inhibitors alone, additional options for this common clinical situation are always welcome. This two-phase study began with 311 patients receiving open-label 8-week escitalopram (flexible dosing, 10–30 mg/day). In a double-blind phase, 139 patients still meeting criteria for major depression (51% male; mean age, 44) continued on escitalopram (mean dose, 20 mg/day) and were randomized to adjunctive ziprasidone (initial dose, 20 mg twice daily; then flexible dosing, 20–80 mg twice daily) or placebo. Medications were manufacturer-supplied.

Mean ziprasidone dose was 98 mg/day. Approximately 70% of z…