Psychopharmacology

, Volume 187, Issue 4, pp 511–514

Quetiapine augmentation in treatment-resistant depression: a naturalistic study

  • Marina Šagud
  • Alma Mihaljević-Peleš
  • Dorotea Mück-Šeler
  • Miro Jakovljević
  • Nela Pivac
Original Investigation

Abstract

Rationale

Treatment-resistant depression (TRD) is a common clinical problem, often complicated with suicidal ideations and greater lifetime functional impairment, and represents a considerable challenge to management and treatment.

Objective

The aim of a prospective, open-label, noncomparative, flexible-dosed 20-week study was to evaluate the effects of quetiapine, as an add-on therapy, in patients with TRD who were refractory to previous treatments.

Method

Eighteen patients with major depressive disorder (DSM-IV criteria) were treated for 20 weeks with quetiapine (mean dose 315±109 mg/day). Patients were evaluated at baseline, weekly from 1 to 9 weeks, and then after 12, 16, and 20 weeks of treatment, using Hamilton rating scale for depression–17 items (HAMD) scale.

Results

Fourteen patients with TRD completed the 20-week open trial with quetiapine. The augmentation with quetiapine significantly reduced total scores and scores listed in the anxiety subscale on the HAMD, and these effects were observed after the fourth week of treatment, while the depressed mood scores were significantly reduced after the fifth week of treatment. Quetiapine add-on treatment significantly decreased the scores listed in the insomnia subscale on the HAMD subscale after the second week of treatment.

Conclusion

Our preliminary data indicate that quetiapine add-on therapy appears to have beneficial effects in the treatment of patients with TRD.

Keywords

Treatment-resistant depression Quetiapine Add-on therapy 

References

  1. Adityanjee, Schulz SC (2002) Clinical use of quetiapine in disease states other than schizophrenia. J Clin Psychiatry 63:32–38PubMedGoogle Scholar
  2. Adson DE, Kushner MG, Kathryn ME, Eiben MA, Schulz (2004) Preliminary experience with adjunctive quetiapine in patients receiving selective serotonin reuptake inhibitors. Depress Anxiety 19:121–126PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Press, Washington, DCGoogle Scholar
  4. Annath J (1998) Treatment-resistant depression. Psychother Psychosom 67:61–70CrossRefGoogle Scholar
  5. Cohrs S, Rodenbeck A, Guan Z, Pohlmann K, Jordan W, Meier A, Rüther E (2004) Sleep-promoting properties of quetiapine in healthy subjects. Psychopharmacology 174:421–429PubMedGoogle Scholar
  6. Cohrs S, Röher C, Jordan W, Meier A, Huether G, Wuttke W, Rüther E, Rodenbeck A (2006) The atypical antipsychotics olanzapine and quetiapine, but not haloperidol, reduce ACTH and cortisol secretion in healthy subjects. Psychopharmacology 185:11–18PubMedCrossRefGoogle Scholar
  7. Devarajan S, Ali J, Dursun SM (2006) Quetiapine plus SSRI in treatment-resistant depression: possible mechanisms. Psychopharmacology 185:402–403. DOI 10.1007/s00213-006-0314-6PubMedCrossRefGoogle Scholar
  8. DeVane CL, Nemeroff CB (2001) Clinical pharmacokinetics of quetiapine an atypical antipsychotic. Clin Pharmacokinet 40:509–522PubMedCrossRefGoogle Scholar
  9. Dodd S, Horgan D, Malhi GS, Berk M (2005) To combine or not to combine? A literature review of antidepressant combination therapy. J Affect Disord 89:1–11PubMedCrossRefGoogle Scholar
  10. Hamilton M (1960) A rating scale for depression. J Neurosurg Psychiatry 23:56–62CrossRefGoogle Scholar
  11. Kennedy SH, Lam RW (2003) Enhancing outcomes in the management of treatment resistant depression: a focus on atypical antipsychotics. Bipolar Disord 5(Suppl 2):36–47PubMedCrossRefGoogle Scholar
  12. Malhi GS, Parker GB, Crawford J, Wilhelm K, Mitchell PB (2005) Treatment-resistant depression: resistant to definition? Acta Psychiatr Scand 112:302–309PubMedCrossRefGoogle Scholar
  13. Nemeroff CB (2005) Use of atypical antipsychotics in refractory depression and anxiety. J Clin Psychiatry 66(Suppl 8):13–21PubMedGoogle Scholar
  14. Nemeroff CB, Kinkead B, Goldstein J (2002) Quetiapine: preclinical studies, pharmacokinetics, drug interactions, and dosing. J Clin Psychiatry 63(Suppl 13):5–11PubMedGoogle Scholar
  15. Pathak S, Johns ES, Kowatch RA (2005) Adjunctive quetiapine for treatment-resistant adolescent major depressive disorder: a case series. J Child Adolesc Psychopharmacology 15:696–702CrossRefGoogle Scholar
  16. Robert S, Hamner MB, Kose S, Ulmer HG, Deitsch SE, Lorberbaum JP (2005) Quetiapine improves sleep disturbances in combat veterans with PTSD (letter). J Clin Psychopharmacol 25:387–388PubMedCrossRefGoogle Scholar
  17. Sharpley AL, Attenburrow ME, Hafizi S, Cowen PJ (2005) Olanzapine increases slow wave sleep and sleep continuity in SSRI-resistant depressed patients. J Clin Psychiatry 66:450–454PubMedCrossRefGoogle Scholar
  18. Sharpley AL, Bhagwagar Z, Hafizi S, Whale WR, Gijsman HJ, Cowen PJ (2003) Risperidone augmentation decreases rapid eye movement sleep and decreases wake in treatment-resistant depressed patients. J Clin Psychiatry 64:192–196PubMedCrossRefGoogle Scholar
  19. Tandon R, Jibson MD (2003) Efficacy of newer generation antipsychotics in the treatment of schizophrenia. Psychoneuroendocrinology 28:9–26PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Marina Šagud
    • 1
  • Alma Mihaljević-Peleš
    • 1
  • Dorotea Mück-Šeler
    • 2
  • Miro Jakovljević
    • 1
  • Nela Pivac
    • 2
  1. 1.Department of PsychiatryClinical Hospital Centre ZagrebZagrebCroatia
  2. 2.Division of Molecular MedicineRudjer Boskovic InstituteZagrebCroatia

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