Pioglitazone as an Adjunct for Moderate to Severe Depressive Disorder

Pioglitazone as an Adjunct for Moderate to Severe Depressive Disorder

The purpose of this study is to determine whether Pioglitazone as an adjunct to Citalopram is effective in treatment of moderate to severe depression

Pioglitazone as a Ppar-gamma agonist is an anti diabetic drug. It was also shown that, it has certain anti inflammatory and neuro-protective effects. In recent years it has been proposed that Ppar-gamma agonists may have effects on mood and cognition. In animal studies and in one human case report as well as a pilot study on human subjects these drugs improved symptoms of depression. A randomized controlled and double blind design will provide further evidence for the efficacy of these drugs in major depressive disorder.

Inclusion Criteria:

• Diagnosis of Major depressive disorder based on DSM-IV TR criteria
• Age 18-50
• Hamilton Depression Rating scale >=22
• Signing the informed consent form
• Citalopram be the drug of choice for the patient irrespective of other eligibility criteria

Exclusion Criteria:

• Problems in other Axes
• Pregnancy and lactation
• Serious or life threatening disease
• taking other antidepressant in the recent month or Electroconvulsive shock in the recent two months, and taking other psychotropic agents
• Diabetes controlled with drugs or insulin (patients with only lifestyle interventions will be included), Liver disease, Congestive heart failure Class III and IV
• Metabolic syndrome