Patients treated successfully with 60 mg per day of the investigational antidepressant Cymbalta® (duloxetine hydrochloride), were less likely to have their emotional and physical symptoms of depression return than those who stopped taking medication after beginning to feel better, according to results of a 38-week study presented today at the American Psychiatric Association meeting.
At the conclusion of the trial, roughly 80 percent of Cymbalta-treated patients remained free of the emotional and physical symptoms of depression. Increasing the dose of Cymbalta from 60 mg once a day to 120 mg (60 mg twice daily) was a benefit for the majority of the smaller group of patients whose symptoms did return (n=29), and did not produce additional side effects. Increasing daily doses of medication is a common clinical practice when patients experience a re-emergence of symptoms.
In clinical practice for the treatment of major depressive disorder, the prevention of relapse and the ability to "rescue" relapsed patients with a previously well-tolerated and efficacious antidepressant is a significant advantage. In this study, the time to relapse was longer in Cymbalta-treated patients than in those who received sugar pills.
"Patients have the best chance of sustaining symptom control when they continue treatment for at least six months after their symptoms resolve," said Michael Detke, M.D., Ph.D., Cymbalta medical director, Eli Lilly and Company. "This study demonstrates that in these patients Cymbalta was effective at keeping depression at bay. These data can also give healthcare practitioners insight into a compound's safety when increasing the dose in instances when relapse does occur."
Complete elimination of symptoms, or remission, is the primary goal of depression treatment. Treating the full spectrum of emotional and physical symptoms to remission puts patients at a decreased risk of relapse.1,2 Among the 19 million Americans with depression annually, an estimated 50 percent will suffer a relapse within two years.3
Cymbalta is a potent serotonin and norepinephrine reuptake inhibitor. The U.S. Food and Drug Administration is reviewing it as a potential treatment for Major Depressive Disorder.
Additional Study Highlights
- By 12 weeks, 68 percent of patients treated with 60 mg of Cymbalta once daily responded to treatment, defined as 50 percent reduction in symptoms, and 53 percent were virtually symptom free, which is the definition of achieving remission.
- By 38 weeks, patients treated with Cymbalta had overall greater symptom control (HAMD17) compared with patients taking sugar pills.
- Cymbalta-treated patients had greater relief of physical symptoms, including headaches, back pain, shoulder pain, and pain while awake and reported increased quality of life (QLDS), by the end of the study. Among patients who relapsed while taking 60 mg of Cymbalta once a day, 62 percent responded to an increased dose, with 38 percent becoming virtually symptom free.
- Among patients whose symptoms returned while taking a sugar pill, 77 percent responded once they resumed taking 60 mg Cymbalta once a day with 57 percent becoming virtually symptom free.
- Cymbalta 60 mg, at both once and twice daily, was well tolerated.
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