P-13-010: Cerebrolysin augmentation in treatment-resistant depression at elderly

Session
P-13: Psychopharmacology II
Tuesday, May 31, 2011, 12:30 - 14:00, Congress Hall Foyer A
Authors
Adela Ciobanu
Univ. of Medicine & Pharmacy
Co-Author(s)
Cristina Petcu
Aurelia Surdu

Objective
Treatment-resistant depression (TRD) presents major challenges for both patients and clinicians. Almost one-third of patients with major depressive disorder not responds to a series of treatments and are considered treatment-resistant. Many pharmacological strategies have been evaluated for the management of TRD, but none have been formally approved for the disorder. Elderly patients with depression have more ischemic lesions on magnetic resonance imaging of the brain than those without depression. At elderly, depression might be associated with neurobiological etiology, especially vascular lesions of the brain.
Cerebrolysin, a mixture derived from pigs' brain tissue, is a protein-based agent that contains small-molecule biologically active neuropeptides. We try to evaluate the efficacy, safety and tolerability in TRD at augmentation with Cerebrolysin.

Method
We included in this study 20 patients (8 men and 12 women) diagnosis with depression resistant at treatment; age > 65 years. We excluded patients diagnosis with dementia, allergic diathesis, epileptic conditions, and renal disease. All patients received antidepressants, but in group A (10 patients), we only made the switch between classes of antidepressants and in group B (10 patients) we made the switch and an augmentation with Cerebrolysin 10 ml/day 10 days / month. Period of study was 24 weeks.
For evaluation we used HAMD-17, CGI-S, GAF at baseline, 2 weeks in first month and monthly to the end of study.

Results
After 2 weeks the patient's symptoms were more improved in group B compare with group A. Patients from group B had a longer time to relapse compared with patients from group A. At the endpoint from A group: 11 patient responders, 4 partial/non-responders, 1 drop out, 4 relapse; B group 16 responders, 2 partial/non-responders, 1 drop out, 1 relapse. Cerebrolysin was generally well tolerated.
Conclusion
Cerebrolysin might have a therapeutic potential as an augmentation strategy for TRD at elderly.