DeBattista and colleagues (
1) concluded that “mifepristone might represent an alternative to traditional treatments of psychosis in psychotic depression.” However, the study was not designed to compare mifepristone with traditional treatments. Mifepristone clearly lacked antidepressant efficacy. As for antipsychotic efficacy, the number needed to treat (NNT) with mifepristone to avoid one exposure to antipsychotic drugs was 17. In the acute treatment context, this high NNT does not signify compelling clinical benefit. When elective treatment was allowed between day 7 and day 28, prior administration of mifepristone made no difference to clinical management. There was no significant reduction of antipsychotic drug or antidepressant drug use or electroconvulsive therapy (ECT) after use of mifepristone from day 1 through day 7.
- DeBattista C.
- Belanoff J.
- Glass S.
- Khan A.
- Horne R.L.
- Blasey C.
- et al.
Mifepristone versus placebo in the treatment of psychosis in patients with psychotic major depression.
Biol Psychiatry. 2006; 60: 1343-1349
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- Mifepristone versus placebo in the treatment of psychosis in patients with psychotic major depression.Biol Psychiatry. 2006; 60: 1343-1349
- Clinical and biological effects of mifepristone treatment for psychotic depression.Neuropsychopharmacology. 2006; 31: 628-636
- An open label trial of C-1073 (mifepristone) for psychotic major depression.Biol Psychiatry. 2002; 52: 386-392
- Is mifepristone useful in psychotic depression?.Neuropsychopharmacology. 2006; 31: 2793-2794
- Corcept therapeutics announces negative results from the first of three phase 3 studies evaluating CORLUX(R) for treating the psychotic features of psychotic major depression.(Accessed August 25, 2006)
- Corcept therapeutics announces negative results from the second of three phase 3 studies evaluating CORLUX(R) for treating the psychotic features of psychotic major depression.(Accessed September 29)
Published online: October 08, 2007
© 2008 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- ReplyBiological PsychiatryVol. 63Issue 1
- PreviewDrs. Rubin and Carroll are critical of the statement that “mifepristone might represent an alternative to traditional treatments of psychosis in psychotic depression.” On the basis of the study’s findings, we disagree and retain our assertion that the data suggest mifepristone as a possible future treatment for the psychotic symptoms of psychotic depression. Beyond efficacy, the significant limitations of current antipsychotic medication, because of their unfavorable side effect profile, would make an alternative treatment welcome.