Approximately 40% of patients treated for depression do not respond to a trial of an antidepressant. The aim of the proposed study was to evaluate the efficacy and safety of switching to vilazodone in patients with major depressive disorder who are unresponsive or only partially responsive to a trial of citalopram. Seventy-nine adults with major depressive disorder were enrolled in an open-label study of citalopram (20 mg/day) for 6 weeks. Those still symptomatic after 6-weeks of citalopram were randomly assigned to either a higher dose of citalopram (40 mg/day) or to vilazodone in a double-blind trial for 6 weeks. Of those who received citalopram 20 mg/day for 6 weeks, 20.3% were 'responders' (defined as ≥50% reduction on the Montgomery-Åsberg Depression Rating Scale). Of the 42 who did not respond, 23 were assigned to citalopram 40 mg/day and 19 were randomized to 40 mg/day of vilazodone. Both groups showed decreases in all outcome measures, but there were no significant differences between groups. Initial nonresponders to a low dose of citalopram seem equally likely to respond to a higher dose of citalopram or to vilazodone. Whether to increase an selective serotonin reuptake inhibitor or switch to a different antidepressant may be best determined on the basis of their adverse event profile.

中文翻译：

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维拉唑酮治疗重大抑郁症的双盲开关研究。

接受抑郁症治疗的患者中约有40％对抗抑郁药的试验没有反应。拟议研究的目的是评估在对西酞普兰试验无反应或仅部分反应的重度抑郁症患者中转用维拉唑酮的疗效和安全性。有79名患有严重抑郁症的成年人参加了西酞普兰（20毫克/天）的开放标签研究，为期6周。在为期6周的双盲试验中，将西酞普兰6周后仍具症状的患者随​​机分配至较高剂量的西酞普兰（40 mg /天）或维拉唑酮中。在接受西酞普兰20毫克/天达6周的患者中，有20.3％是“应答者”（在蒙哥马利-阿斯伯格抑郁量表上定义为≥50％的降低）。在42位未回应的人中，23例被分配给西酞普兰40毫克/天，而19例被随机分配给维拉唑酮40毫克/天。两组均显示所有结局指标均下降，但组间无显着差异。最初对低剂量西酞普兰无反应的人似乎同样有可能对较高剂量的西酞普兰或维拉唑酮起反应。根据其不良事件情况，最好确定是否增加选择性5-羟色胺再摄取抑制剂或改用其他抗抑郁药。