Clomipramine/bentazepam combination in the treatment of major depressive disorders

Abstract

Eighty-three patients were recruited in a multicentre study concerning the usefulness of benzodiazepines (BZ) in major depressive disorders, diagnosed according to the DSM-III-R criteria. After 1 week wash-out, patients were randomized to clomipramine (CLMP) or CLMP plus bentazepam (BTZ) treatments (47 and 36 patients respectively). It was necessary to add hypnotics, usually a BZ, in 11 patients in the CLMP group and in one patient in the CLMP+BTZ group. The clinical improvement was faster in the group treated with CLMP+BTZ and, at the end of 6 weeks of treatment, the mean score in Hamilton Anxiety Scale (HAS) was lower than the one found in the group treated with CLMP. There were no significant differences found in Hamilton Depression Scale (HDS) between the groups. The side-effects observed were those due to CLMP, and only drowsiness was more frequent in the CLMP+BTZ group. However, the CLMP+BTZ combination was equally or better tolerated by patients than by those treated with CLMP alone. Similar results were found in hospitalized as well as in outpatients. The tricyclic antidepressant (TCA)/BZ association showed better results than TCA alone, producing a symptomatic improvement extensive to the anxious components of depression.

Antidepressants plus benzodiazepines for adults with major depression

“…The review included 10 studies (Calcedo Ordonez 1992;Dominguez 1984;Fawcett 1987;Feet 1985;Feighner 1979;Nolen 1993;Scharf 1986;Smith 1998;Smith 2002;Yamaoka 1994). See Characteristics of included studies table.…”

“…One study was an open trial so the risk of bias for blinding of outcome assessment was high (Calcedo Ordonez 1992). No details were provided on who performed the outcome assessments in the other studies so the risk of bias for blinding of outcome assessment were unclear.…”

“…Therefore, three studies suggested that combination therapy outperformed antidepressant monotherapy when anxiety or insomnia were present, while such superiority for depression without these accompanying symptoms remained to be further examined (Feighner 1979;Smith 1998;Smith 2002). Fourth, we included one study with a dropout rate above 40% (Yamaoka 1994), and four studies with dropout rate above 20% (Calcedo Ordonez 1992;Dominguez 1984;Feighner 1979;Smith 2002). This may have introduced bias, but the findings of this review were robust to sensitivity analysis excluding trials with a high risk of bias because of incomplete outcome data.…”

Clinical efficacy of tandospirone augmentation in patients with major depressive disorder: A randomized controlled trial

“…Although there have been several reports that the addition of a benzodiazepine to antidepressants may improve the symptoms of MDD, 17–20 there are reports that the combination had no efficacy 21 . Alternatively, it was also warned that the combined therapy might cause adverse events including dependence or the worsening of MDD 22,23 .…”