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Venlafaxine 37.5 mg la thuoc gi /d and lamotrigine 25.6 mg/d, both with dose escalation during study to avoid drug interactions. A combination of lamotrigine or olanzapine with aripiprazole was also provided. Patients were assessed for their response to treatment as previously defined by the study investigator. A change in clinical status defined as a ≥50% reduction in depressive symptoms or by the clinician determined need for additional or changed medication was defined as a "response." Efficacy was defined as response (≥50%), remission (≥15%) and improvement (≥5%) in the mean score of Hamilton Rating Scale for Depression (HAM-D). The primary efficacy measure was change of HAM-D score from baseline to week 12 for the full cohort of patients randomly assigned to receive either lamotrigine alone, olanzapine with risperidone, or a combination of the two. In addition, all patients were assessed for the HAM-D score at week 6, 12 and 24. If any treatment resulted in a worsening HAM-D scores, then the patient was considered "inflamed;" further studies were stopped until HAM-D scores returned to normal or the inflamed patients improved. Efficacy of the three monotherapies with aripiprazole was compared lamotrigine from pre to week 12. Patients were included if they met all eligibility criteria, provided a drug-free baseline HAM-D score > 10, were randomized to an intervention and had received at least 12 weeks of treatment (2 months for lamotrigine). Randomization was stratified according to aripiprazole dose (0.3, 0.5, 1 or 2 kg/d) and baseline HAM-D score at baseline. The randomization procedure resulted in equal numbers of olanzapine and aripiprazole assigned to each arm. The three doses of aripiprazole were distributed according to the following distribution of doses in Table 2: This study was conducted as an extension of a randomized, placebo-controlled, triple-blind study that used olanzapine alone (n=13) and risperidone (n=12) at a dose of 0.5-1.0 mg/d. In that study, patients received lamotrigine (n=10) or risperidone and no additional therapies. In the present study, olanzapine was used for 1 month as a placebo, then used for another 3 weeks as a maintenance monotherapy. During the study, patients treated daily with olanzapine received a dose of 0.5 mg/kg/d that was increased to 1.0 mg/kg/d as needed, depending on the patient's response. dosage of aripiprazole used in the present study was 0.3 mg/kg/d divided in four doses every other day over the first three weeks, and thereafter was increased in 5-mg doses per day. As with the previous trial (3), olanzapine was used as a placebo for 1 month. Study Adherence The primary efficacy measure in this study was the mean HAM-D score at end of randomization. After randomization, patients were randomly assigned to receive any of the three antidepressive agents or no additional therapy. This 77 canada pharmacy coupon code study was designed to measure adherence treatment; as such, the primary end point was not to compare the efficacy of three antidepressive agents, but to examine the effectiveness of maintenance regimen in terms maintaining the same level of depressive symptoms regardless the individual patient's response. To compare adherence treatment, the number of patients who missed any prescribed therapy was measured. Treatment provided at every visit throughout the study and was continued until the patient had completed study. Patients were considered to have missed treatment if they were diagnosed as in need of additional or changed medication. The number of patients who were missed at least once and who were eligible for the study was used to monitor adherence. Analyses were performed on the basis of patients who did not miss treatment. The analyses were performed among entire cohort of patients who provided information. The proportion of remaining patients missing was used in the comparisons with lamotrigine, olanzapine alone, and the combination of two medications. Data Analysis We used a mixed-effects analysis to compare the effects of each three antidepressive agents over time and to compare the differences in mean scores of Hamilton Rating Scale for Depression between patients assigned to one drug and those assigned to the other drugs administered for 24 weeks. Our primary outcome was the change of HAM-D score from baseline to week 12, as described above. We also used a mixed-effects analysis to compare efficacy measures over time and to compare the difference among three ant.

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