Study Assessing Use of Mood Stabilizers (Sodium Valproate and Oxcarbazepine) as an Augmentation Strategy in Patients of Treatment-resistant Depression

Abstract

Abstract Background: Treatment-resistant depression (TRD) is a major challenge, with a significant proportion of patients failing to achieve remission with initial antidepressant treatment. As per literature, augmentation strategies using nonantidepressant agents have been explored to overcome partial or lack of response. This study aimed to determine the efficacy of adding mood stabilizers, sodium valproate, and oxcarbazepine as augmenting agents in patients with TRD. Methodology: This prospective and observational study recruited 106 patients with TRD from a tertiary care center in Navi Mumbai, India. Patients were augmented with either sodium valproate (n = 53) or oxcarbazepine (n = 53) in addition to their ongoing antidepressant and anti-anxiety medications. The Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) were administered at baseline, at 2 weeks, and at 4 weeks after augmentation. Treatment response was documented, and results were statistically analyzed. Results: Both augmentation groups showed significant improvements in HAM-D and HAM-A scores at 2 and 4 weeks compared to baseline (P < 0.001). However, the sodium valproate group demonstrated superior efficacy, with a greater reduction in HAM-D scores as compared to the oxcarbazepine group at 2 weeks (25.60 vs. 21.98, P = 0.001) and 4 weeks (34.06 vs. 30.64, P = 0.001). Conclusion: The addition of mood stabilizers, sodium valproate, and oxcarbazepine, as augmentation agents led to significant improvement in patients with TRD. Sodium valproate exhibited superior efficacy as compared to oxcarbazepine, suggesting its potential as a valuable augmentation strategy in the management of TRD.