Atypical antipsychotic augmentation in major depressive disorder: a meta-analysis of placebo-controlled randomized trials
Abstract
OBJECTIVE: The authors sought to determine by meta-analysis the efficacy and tolerability of adjunctive atypical antipsychotic agents in major depressive disorder. METHOD: Searches were conducted of MEDLINE/PubMed (1966 to January 2009), the Cochrane database, abstracts of major psychiatric meetings since 2000, and online trial registries. Manufacturers of atypical antipsychotic agents without online registries were contacted. Trials selected were acute-phase, parallel-group, double-blind controlled trials with random assignment to adjunctive atypical antipsychotic or placebo. Patients had nonpsychotic unipolar major depressive disorder that was resistant to prior antidepressant treatment. Response, remission, and discontinuation rates were either reported or obtained. Data were extracted by one author and checked by the second. Data included study design, number of patients, patient characteristics, methods of establishing treatment resistance, drug doses, duration of the adjunctive trial, depression scale used, response and remission rates, and discontinuation rates for any reason or for adverse events. RESULTS: Sixteen trials with 3,480 patients were pooled using a fixed-effects meta-analysis. Adjunctive atypical antipsychotics were significantly more effective than placebo (response: odds ratio=1.69, 95% CI=1.46-1.95, z=7.00, N=16, p<0.00001; remission: odds ratio=2.00, 95% CI=1.69-2.37, z=8.03, N=16, p<0.00001). Mean odds ratios did not differ among the atypical agents and were not affected by trial duration or method of establishing treatment resistance. Discontinuation rates for adverse events were higher for atypical agents than for placebo (odds ratio=3.91, 95% CI=2.68-5.72, z=7.05, N=15, p<0.00001). CONCLUSIONS: Atypical antipsychotics are effective augmentation agents in major depressive disorder but are associated with an increased risk of discontinuation due to adverse events.
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Previous studies emphasize the use of these agents as a pivotal point to overcome treatment resistance.
“Additionally previous studies emphasize the use of these agents as a pivotal point to overcome treatment resistance (Nelson and Papakostas, 2009; Rafeyan et al., 2020).”
From Augmentation strategies for treatment resistant major depression: A systematic review and network meta-analysis (2022) · cites this paper as Nelson and Papakostas, 2009
Cites
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763 · see citing works
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817 · see citing works
A new depression scale designed to be sensitive to change
Montgomery, S. A., & Åsberg, M. (1979) · British Journal of Psychiatry · doi:10.1192/bjp.134.4.382 · Cited by 13,962 · see citing works
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2003) · JAMA · doi:10.1001/jama.289.23.3095 · Cited by 7,988 · see citing works
Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., Niederehe, G., Thase, M. E., Lavori, P. W., Lebowitz, B. D., et al. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.11.1905 · Cited by 5,643 · see citing works
Deeks, J. J., Altman, D. G., & Bradburn, M. J. (2001) · Systematic Reviews in Health Care · doi:10.1002/9780470693926.ch15 · Cited by 2,163 · see citing works
Marcus, R. N., McQuade, R. D., Carson, W. H., Hennicken, D., Fava, M., Simon, J. S., Trivedi, M. H., Thase, M. E., & Berman, R. M. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31816774f9 · Cited by 518 · see citing works
A Novel Augmentation Strategy for Treating Resistant Major Depression
Shelton, R. C., Tollefson, G. D., Tohen, M. F., Stahl, S. M., Gannon, K. S., Jacobs, T. G., Buras, W. R., Bymaster, F. P., Zhang, W., Spencer, K. A., et al. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.1.131 · Cited by 501 · see citing works
Berman, R. M., Marcus, R. N., Swanink, R., McQuade, R. D., Carson, W. H., Corey-Lisle, P. K., & Khan, A. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0604 · Cited by 409 · see citing works
Jensen, N., Rodriguiz, R. M., Caron, M. G., Wetsel, W. C., Rothman, R. B., & Roth, B. L. (2007) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301646 · Cited by 319 · see citing works
Crossley, N. A., & Bauer, M. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0617 · Cited by 246 · see citing works
Risperidone Augmentation of Selective Serotonin Reuptake Inhibitors in Major Depression
Ostroff, R. B., & Nelson, J. C. (1999) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v60n0410 · Cited by 245 · see citing works
Self-citationPapakostas, G. I., Shelton, R. C., Smith, J., & D, M. F. M. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0602 · Cited by 242 · see citing works
Self-citationZhang, W. Y. (2000) · Neuropsychopharmacology · doi:10.1016/s0893-133x(00)00119-6 · Cited by 233 · see citing works
Thase, M. E., Corya, S. A., Osuntokun, O., Case, M., Henley, D. B., Sanger, T. M., Watson, S. B., & Dubé, S. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0207 · Cited by 228 · see citing works
Corya, S. A., Williamson, D., Sanger, T. M., Briggs, S. D., Case, M., & Tollefson, G. (2006) · Depression and Anxiety · doi:10.1002/da.20130 · Cited by 170 · see citing works
Corya, S. A. (2005) · doi:10.4088/jcp.v66n1012 · Cited by 162 · see citing works
McIntyre, A., Gendron, A., & McIntyre, A. (2007) · Depression and Anxiety · doi:10.1002/da.20275 · Cited by 145 · see citing works
Risperidone for Treatment-Refractory Major Depressive Disorder: A Randomized Trial
Mahmoud, R. A., Pandina, G. J., Turkoz, I., Kosik-Gonzalez, C., Canuso, C. M., Kujawa, M. J., & Gharabawi-Garibaldi, G. M. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-9-200711060-00003 · Cited by 140 · see citing works
Atypicality of Atypical Antipsychotics
Farah, A. (2005) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.v07n0602 · Cited by 128 · see citing works
Receptor Mechanisms in the treatment of Schizophrenia
Reynolds, G. P. (2004) · Journal of Psychopharmacology · doi:10.1177/026988110401800303 · Cited by 117 · see citing works
Pharmacological profile of neuroleptics at human monoamine transporters
Tatsumi, M., Jansen, K. R., Blakely, R., et al. (1999) · European Journal of Pharmacology · doi:10.1016/s0014-2999(99)00005-9 · Cited by 110 · see citing works
Keitner, G. I., Garlow, S. J., Ryan, C. E., Ninan, P. T., Solomon, D. A., Nemeroff, C. B., & Keller, M. B. (2009) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2008.05.003 · Cited by 108 · see citing works
Lithium Augmentation of Nortriptyline for Subjects Resistant to Multiple Antidepressants
Nierenberg, A. A., Papakostas, G. I., Petersen, T., Montoya, H. D., Worthington, J. J., Tedlow, J. R., Alpert, J. E., & D, M. F. M. (2003) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-200302000-00013 · Cited by 103 · see citing works
Self-citationReeves, H., Batra, S., May, R. S., Zhang, R., Dahl, D. C., & Li, X. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0805 · Cited by 102 · see citing works
Zohar, J., & Belmaker, R. H. (1987) · Medical Entomology and Zoology · Cited by 91 · see citing works
Characterization of aripiprazole partial agonist activity at human dopamine D3 receptors
Tadori, Y., Forbes, R. A., McQuade, R. D., & Kikuchi, T. (2008) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2008.09.008 · Cited by 66 · see citing works
On-Line Manuscript Submission and Peer Review
(2003) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v64n0102 · Cited by 44 · see citing works
Augmentation Strategies for Treatment of Unipolar Major Depression
Nelson, J. C. (1997) · KARGER eBooks · doi:10.1159/000061657 · Cited by 14 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Kennedy, S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., Hasnain, M., Jollant, F., Levitt, A. J., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659417 · Cited by 1,150 · see citing works
Cleare, A., Pariante, C., Young, A., Anderson, I., Christmas, D., Cowen, P., Dickens, C., Ferrier, I., Geddes, J., Gilbody, S., et al. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881115581093 · Cited by 759 · see citing works
Berlim, M. T., van den Eynde, F., Tovar-Perdomo, S., & Daskalakis, Z. J. (2014) · Psychological Medicine · doi:10.1017/s0033291713000512 · Cited by 620 · see citing works
Drossman, D. A., Tack, J., Ford, A. C., Szigethy, E., Törnblom, H., & Van Oudenhove, L. (2018) · Gastroenterology · doi:10.1053/j.gastro.2017.11.279 · Cited by 470 · see citing works
Depression in type 2 diabetes mellitus: prevalence, impact, and treatment
Semenkovich, K., Brown, M. E., Svrakic, D. M., & Lustman, P. J. (2015) · Drugs · doi:10.1007/s40265-015-0347-4 · Cited by 447 · see citing works
Treatment-resistant depression: Definitions, review of the evidence, and algorithmic approach
McIntyre, R. S., Filteau, M.-J., Martin, L., Patry, S., Carvalho, A., Cha, D. S., Barakat, M., & Miguelez, M. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.10.043 · Cited by 421 · see citing works
Treatment of Adult Depression in the United States
Olfson, M., Blanco, C., & Marcus, S. C. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.5057 · Cited by 352 · see citing works
Efficacy and effectiveness of antidepressants: current status of research
Pigott, H. E., Leventhal, A. M., Alter, G. S., & Boren, J. J. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000318293 · Cited by 347 · see citing works
Velligan, D. I., Sajatovic, M., Hatch, A., Kramata, P., & Docherty, J. (2017) · Patient Preference and Adherence · doi:10.2147/ppa.s124658 · Cited by 333 · see citing works
McAllister-Williams, R. H., Arango, C., Blier, P., Demyttenaere, K., Falkai, P., Gorwood, P., Hopwood, M., Javed, A., Kasper, S., Malhi, G. S., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.02.023 · Cited by 278 · see citing works
Lenze, E. J., Mulsant, B. H., Blumberger, D. M., Karp, J. F., Newcomer, J. W., Anderson, S. J., Dew, M. A., Butters, M. A., Stack, J. A., Begley, A. E., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00308-6 · Cited by 283 · see citing works
Spielmans, G. I., Berman, M. I., Linardatos, E., Rosenlicht, N. Z., Perry, A., & Tsai, A. C. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001403 · Cited by 275 · see citing works
Nuñez, N. A., Joseph, B., Pahwa, M., Kumar, R., Resendez, M. G., Prokop, L. J., Veldic, M., Seshadri, A., Biernacka, J. M., Frye, M. A., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.134 · Cited by 215 · see citing works
Treatment of Resistant Depression in Adolescents (TORDIA): week 24 outcomes
Emslie, G. J., Mayes, T., Porta, G., Vitiello, B., Clarke, G., Wagner, K. D., Asarnow, J. R., Spirito, A., Birmaher, B., Ryan, N., et al. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09040552 · Cited by 217 · see citing works
Bauer, M., Severus, E., Köhler, S., Whybrow, P. C., Angst, J., Möller, H.-J., & on behalf of the Wfsbp Task Force on Treatment Guidelines for Unipolar Depressive Disorders (2015) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2014.1001786 · Cited by 199 · see citing works
Caemmerer, J., Correll, C. U., & Maayan, L. (2012) · Schizophrenia Research · doi:10.1016/j.schres.2012.03.017 · Cited by 182 · see citing works
Thase, M. E., Youakim, J. M., Skuban, A., Hobart, M., Augustine, C., Zhang, P., McQuade, R. D., Carson, W. H., Nyilas, M., Sanchez, R., et al. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14m09688 · Cited by 182 · see citing works
Kaster, T. S., Daskalakis, Z. J., Noda, Y., Knyahnytska, Y., Downar, J., Rajji, T. K., Levkovitz, Y., Zangen, A., Butters, M. A., Mulsant, B. H., et al. (2018) · Neuropsychopharmacology · doi:10.1038/s41386-018-0121-x · Cited by 174 · see citing works
Pehrson, A. L., & Sanchez, C. (2014) · CNS Spectrums · doi:10.1017/s1092852913000540 · Cited by 161 · see citing works
Fava, M., Mischoulon, D., Iosifescu, D., Witte, J., Pencina, M., Flynn, M., Harper, L., Levy, M., Rickels, K., & Pollack, M. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000332050 · Cited by 141 · see citing works
Novel neuroimmunologic therapeutics in depression: A clinical perspective on what we know so far
Roman, M., & Irwin, M. R. (2020) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2019.09.016 · Cited by 132 · see citing works
Farahani, A., & Correll, C. U. (2012) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.11r07324 · Cited by 131 · see citing works
Carvalho, A. F., Berk, M., Hyphantis, T. N., & McIntyre, R. S. (2014) · Psychotherapy and Psychosomatics · doi:10.1159/000357500 · Cited by 123 · see citing works
Durgam, S., Earley, W., Guo, H., Li, D., Németh, G., Laszlovszky, I., Fava, M., & Montgomery, S. A. (2016) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.15m10070 · Cited by 125 · see citing works
Sackeim, H. A., Aaronson, S. T., Bunker, M. T., Conway, C. R., Demitrack, M. A., George, M. S., Prudic, J., Thase, M. E., & Rush, A. J. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.03.021 · Cited by 109 · see citing works
The Impact of (the Concept of) Treatment-Resistant Depression: An Opinion Review
Demyttenaere, K., & Van Duppen, Z. (2019) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyy052 · Cited by 98 · see citing works
Vázquez, G. H., Bahji, A., Undurraga, J., Tondo, L., & Baldessarini, R. J. (2021) · Journal of Psychopharmacology · doi:10.1177/02698811211013579 · Cited by 95 · see citing works
Neuroplasticity and the next wave of antidepressant strategies
Hayley, S., & Litteljohn, D. (2013) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2013.00218 · Cited by 92 · see citing works
Papadimitropoulou, K., Vossen, C., Karabis, A., Donatti, C., & Kubitz, N. (2017) · Current Medical Research and Opinion · doi:10.1080/03007995.2016.1277201 · Cited by 91 · see citing works
Faridhosseini, F., Sadeghi, R., Farid, L., & Pourgholami, M. (2014) · Human Psychopharmacology: Clinical and Experimental · doi:10.1002/hup.2401 · Cited by 89 · see citing works
Culpepper, L., Muskin, P. R., & Stahl, S. M. (2015) · The American Journal of Medicine · doi:10.1016/j.amjmed.2015.07.001 · Cited by 77 · see citing works
Woo, Y., Seo, H.-J., McIntyre, R., & Bahk, W.-M. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17010080 · Cited by 79 · see citing works
Pharmacological Augmentation in Unipolar Depression: A Guide to the Guidelines
Taylor, R. W., Marwood, L., Oprea, E., DeAngel, V., Mather, S., Valentini, B., Zahn, R., Young, A. H., & Cleare, A. J. (2020) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyaa033 · Cited by 76 · see citing works
The Efficacy of Psychostimulants in Major Depressive Episodes: A Systematic Review and Meta-Analysis
McIntyre, R. S., Lee, Y., Zhou, A. J., Rosenblat, J. D., Peters, E. M., Lam, R. W., Kennedy, S. H., Rong, C., & Jerrell, J. M. (2017) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000723 · Cited by 75 · see citing works
New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity
Huang, Y.-J., Lane, H.-Y., & Lin, C.-H. (2017) · Neural Plasticity · doi:10.1155/2017/4605971 · Cited by 74 · see citing works
Nelson, J. C., & Spyker, D. A. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.16050523 · Cited by 67 · see citing works
Self-citationRacial-ethnic disparities in outpatient mental health care in the United States
Olfson, M., Zuvekas, S. H., McClellan, C., Wall, M. M., Hankerson, S. H., & Blanco, C. (2023) · Psychiatric Services · doi:10.1176/appi.ps.20220365 · Cited by 66 · see citing works
Dold, M., Kautzky, A., Bartova, L., Rabl, U., Souery, D., Mendlewicz, J., Porcelli, S., Serretti, A., Zohar, J., Montgomery, S., et al. (2016) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2016.10.005 · Cited by 66 · see citing works
Suppes, T., Kroger, H., Pikalov, A., & Loebel, A. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.03.012 · Cited by 65 · see citing works
A critical review of pharmacotherapy for major depressive disorder.
Dupuy, J. M., Ostacher, M. J., Huffman, J., Perlis, R. H., & Nierenberg, A. A. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145711000083 · Cited by 61 · see citing works
Challenging Treatment-Resistant Major Depressive Disorder: A Roadmap for Improved Therapeutics
de Sousa, R. T., V. Zanetti, M., R. Brunoni, A., & Machado-Vieira, R. (2015) · Current Neuropharmacology · doi:10.2174/1570159x13666150630173522 · Cited by 43 · see citing works
“Two meta-analyses of placebo-controlled trials have demonstrated that adjunctive AAP is an effective approach in the treatment of TRD, with a NNT of nearly 9 [32, 33].”
The Neglected Role of Psychotherapy for Treatment-Resistant Depression
Markowitz, J. C., Wright, J. H., Peeters, F., Thase, M. E., Kocsis, J. H., & Sudak, D. M. (2022) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2021.21050535 · Cited by 41 · see citing works
Dold, M., Bartova, L., & Kasper, S. (2020) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyaa034 · Cited by 34 · see citing works
Rational site-directed pharmacotherapy for major depressive disorder
Blier, P. (2014) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145713000400 · Cited by 29 · see citing works
Rapastinel - an investigational NMDA-R modulator for major depressive disorder: evidence to date
Ragguett, R.-M., Rong, C., Kratiuk, K., & McIntyre, R. S. (2019) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2019.1559295 · Cited by 30 · see citing works
Using Measurement Strategies to Identify and Monitor Residual Symptoms
McIntyre, R. S. (2013) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.12084su1c.03 · Cited by 25 · see citing works
Strategic use of new generation antidepressants for depression: SUN(^_^)D study protocol
Furukawa, T. A., Akechi, T., Shimodera, S., Yamada, M., Miki, K., Watanabe, N., Inagaki, M., & Yonemoto, N. (2011) · Trials · doi:10.1186/1745-6215-12-116 · Cited by 23 · see citing works
Spielmans, G. I., Berman, M. I., Linardatos, E., Rosenlicht, N. Z., Perry, A., & Tsai, A. C. (2016) · Focus · doi:10.1176/appi.focus.140202 · Cited by 20 · see citing works
Ziprasidone augmentation for anxious depression
Ionescu, D. F., Shelton, R. C., Baer, L., Meade, K. H., Swee, M. B., Fava, M., & Papakostas, G. I. (2016) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000133 · Cited by 10 · see citing works
Self-citation
- Authors
- Nelson, J. C., & Papakostas, G. I.
- Affiliations
- University of California, San Francisco (US)
- Venue
- American Journal of Psychiatry
- Published
- 2009-09
- Volume
- 166
- Issue
- 9
- Pages
- 980-991
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2104518967
- Cited by
- 552
- References
- 29
- Citations by year
- 2026: 19 · 2025: 17 · 2024: 13 · 2023: 23 · 2022: 27 · 2021: 20 · 2020: 34 · 2019: 23 · 2018: 26 · 2017: 30 · 2016: 45 · 2015: 43 · 2014: 50 · 2013: 60 · 2012: 35
- FWCI
- 3.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Abbott Laboratories
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Jazz Pharmaceuticals
- ACADIA Pharmaceuticals
- H. Lundbeck A/S
- Health Resources and Services Administration
- National Institute of Mental Health
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- atypical antipsychotics, major depressive disorder, antidepressant augmentation, treatment-resistant depression, adjunctive therapy, remission, adverse events, drug tolerability, placebo comparison
- MeSH terms
- Major Depressive Disorder, Drug Therapy, Combination, Humans, Placebos, Psychiatric Status Rating Scales, Antipsychotic Agents, United States, Randomized Controlled Trials as Topic, MEDLINE, Treatment Outcome
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