Quetiapine Extended Release
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Quetiapine extended release (XR) is a once-daily oral formulation of the atypical antipsychotic quetiapine that is available for use as adjunctive therapy in major depressive disorder (MDD).
Systemic quetiapine exposure after orally administered quetiapine XR is similar to that of quetiapine immediate release at the same dosage, although quetiapine XR is absorbed more slowly and plasma concentrations are more stable over time.
In two 6-week, randomized, double-blind, placebo-controlled, multinational trials in patients with MDD with an inadequate response to antidepressants, quetiapine XR 300 mg/day adjunctive to antidepressant reduced depressive symptoms significantly more than antidepressant plus placebo, according to changes in Montgomery-Åsberg Depression Rating Scale (MADRS) total scores. In one trial, adjunctive quetiapine XR 150mg/day also led to significantly greater reductions in MADRS total scores than antidepressant plus placebo.
MDD response rates were significantly higher with adjunctive quetiapine XR 300 mg/day (but not 150 mg/day) than with antidepressant plus placebo. The numbers needed to treat to achieve an additional response over antidepressant plus placebo were 11–18 and 8–9 in the quetiapine XR 150 and 300 mg/day dosage groups, respectively.
Treatment-emergent adverse events were mostly of mild to moderate severity; 1% of adjunctive quetiapine XR and 1.3% of antidepressant plus placebo recipients reported serious adverse events.
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- 2.World Health Organization. The global burden of disease: 2004 update [online]. Available from URL: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf [Accessed 2011 Mar 7]
- 3.Janicak PG, Dowd SM. Treatment-resistant depression: an update on diagnosis and management. Psychopharm Rev 2009; 44 (6): 41–8Google Scholar
- 7.European Medicines Agency. Questions and answers on Seroquel XR and associated names (50, 150, 200, 300 and 400 mg prolonged-release tablets containing quetiapine): outcome of a procedure under Article 6(13) of Regulation (EC) 1084/2003 as amended. Available from URL: http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Seroquel_XR_6/WC500089663.pdf [Accessed 2010 Jul 14]
- 8.The electronic Medicines Compendium (eMC). Seroquel XR 50mg, 150mg, 200mg, 300mg, 400mg prolonged-release tablets: summary of product characteristics [online]. Available from URL: http://www.medicines.org.uk/emc/document.aspx?documentid=21175&docType=SPC [Accessed 2011 Feb 8]
- 9.AstraZeneca. Seroquel XR (quetiapine fumarate) tablets: prescribing information [online]. Available from URL: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/022047s023s027tbl.pdf [Accessed 2011 Jul 21]
- 14.Datto C, Berggren L, Patel JB, et al. Self-reported sedation profile of immediate-release quetiapine fumarate compared with extended-release quetiapine fumarate during dose initiation: a randomized, double-blind, crossover study in healthy adult subjects. Clin Ther 2009 Mar; 31 (3): 492–502PubMedCrossRefGoogle Scholar
- 15.Nord M, Nyberg S, Brogren J, et al. Comparison of D2 dopamine receptor occupancy after oral administration of quetiapine fumarate immediate-release and extended-release formulations in healthy subjects. Int J Neuropsychopharmacol. Epub 2011 Apr 11Google Scholar
- 17.Gedge L, Lazowski L, Murray D, et al. Effects of quetiapine on sleep architecture in patients with unipolar or bipolar depression. Neuropsychiatric Dis Treat 2010; 6 (1): 501–8Google Scholar
- 22.El-Khalili N, Joyce M, Atkinson S, et al. Extended-release quetiapine fumarate (quetiapine XR) as adjunctive therapy in major depressive disorder (MDD) in patients with an inadequate response to ongoing antidepressant treatment: a multicentre, randomized, double-blind, placebo-controlled study. Int J Neuropsychopharmacol 2010; 13 (7): 917–32PubMedCrossRefGoogle Scholar
- 24.Bandelow B, Bauer M, Vieta E, et al. Pooled analysis of the efficacy of adjunctive quetiapine XR in patients with major depressive disorder and high or low levels of baseline anxiety [abstract no. P06]. Int J Psychiat Clin Pract 2010; 14 Suppl. 1: 19Google Scholar
- 25.Bauer M, Dell’Osso L, Kasper S, et al. Quetiapine XR monotherapy, quetiapine XR+ongoing antidepressants and lithium+ongoing antidepressants in patients with treatment-resistant major depressive disorder [abstract no. p-09.004]. Int J Neuropsychopharmacol 2010; 13 Suppl. 1: 143Google Scholar