Skip to main content

Advertisement

Log in

Quetiapine augmentation in treatment-resistant depression: a naturalistic study

  • Original Investigation
  • Published:
Psychopharmacology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Adityanjee, Schulz SC (2002) Clinical use of quetiapine in disease states other than schizophrenia. J Clin Psychiatry 63:32–38

    PubMed  CAS  Google Scholar 

  • Adson DE, Kushner MG, Kathryn ME, Eiben MA, Schulz (2004) Preliminary experience with adjunctive quetiapine in patients receiving selective serotonin reuptake inhibitors. Depress Anxiety 19:121–126

    Article  PubMed  CAS  Google Scholar 

  • American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Press, Washington, DC

    Google Scholar 

  • Annath J (1998) Treatment-resistant depression. Psychother Psychosom 67:61–70

    Article  Google Scholar 

  • Cohrs S, Rodenbeck A, Guan Z, Pohlmann K, Jordan W, Meier A, Rüther E (2004) Sleep-promoting properties of quetiapine in healthy subjects. Psychopharmacology 174:421–429

    PubMed  CAS  Google Scholar 

  • 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 185:11–18

    Article  PubMed  CAS  Google Scholar 

  • Devarajan S, Ali J, Dursun SM (2006) Quetiapine plus SSRI in treatment-resistant depression: possible mechanisms. Psychopharmacology 185:402–403. DOI 10.1007/s00213-006-0314-6

    Article  PubMed  CAS  Google Scholar 

  • DeVane CL, Nemeroff CB (2001) Clinical pharmacokinetics of quetiapine an atypical antipsychotic. Clin Pharmacokinet 40:509–522

    Article  PubMed  CAS  Google Scholar 

  • 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 89:1–11

    Article  PubMed  CAS  Google Scholar 

  • Hamilton M (1960) A rating scale for depression. J Neurosurg Psychiatry 23:56–62

    Article  CAS  Google Scholar 

  • Kennedy SH, Lam RW (2003) Enhancing outcomes in the management of treatment resistant depression: a focus on atypical antipsychotics. Bipolar Disord 5(Suppl 2):36–47

    Article  PubMed  CAS  Google Scholar 

  • Malhi GS, Parker GB, Crawford J, Wilhelm K, Mitchell PB (2005) Treatment-resistant depression: resistant to definition? Acta Psychiatr Scand 112:302–309

    Article  PubMed  CAS  Google Scholar 

  • Nemeroff CB (2005) Use of atypical antipsychotics in refractory depression and anxiety. J Clin Psychiatry 66(Suppl 8):13–21

    PubMed  CAS  Google Scholar 

  • Nemeroff CB, Kinkead B, Goldstein J (2002) Quetiapine: preclinical studies, pharmacokinetics, drug interactions, and dosing. J Clin Psychiatry 63(Suppl 13):5–11

    PubMed  CAS  Google Scholar 

  • Pathak S, Johns ES, Kowatch RA (2005) Adjunctive quetiapine for treatment-resistant adolescent major depressive disorder: a case series. J Child Adolesc Psychopharmacology 15:696–702

    Article  Google Scholar 

  • 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 25:387–388

    Article  PubMed  Google Scholar 

  • 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 66:450–454

    Article  PubMed  CAS  Google Scholar 

  • 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 64:192–196

    Article  PubMed  CAS  Google Scholar 

  • Tandon R, Jibson MD (2003) Efficacy of newer generation antipsychotics in the treatment of schizophrenia. Psychoneuroendocrinology 28:9–26

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

Thanks are due to the staff of the Clinical Hospital Centre Zagreb, Zagreb, Croatia. The experiments comply with the current laws of Croatia. The research was supported by the Croatian Ministry of Sciences, Education and Health, grant numbers 0098088 and 0108106.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nela Pivac.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Šagud, M., Mihaljević-Peleš, A., Mück-Šeler, D. et al. Quetiapine augmentation in treatment-resistant depression: a naturalistic study. Psychopharmacology 187, 511–514 (2006). https://doi.org/10.1007/s00213-006-0452-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00213-006-0452-x

Keywords

Navigation