Posted by Phillipa on October 24, 2013, at 18:35:38
For treatment resistant Major Depressive Disorder per pub med. Phillipa
J Affect Disord. 2013 Oct;151(1):209-19. doi: 10.1016/j.jad.2013.05.079. Epub 2013 Jun 27.
Extended-release quetiapine fumarate (quetiapine XR) monotherapy and quetiapine XR or lithium as add-on to antidepressants in patients with treatment-resistant major depressive disorder.
Bauer M, Dell'osso L, Kasper S, Pitchot W, Dencker Vansvik E, Köhler J, Jørgensen L, Montgomery SA.
SourceDepartment of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307 Dresden, Germany. Michael.Bauer@uniklinikum-dresden.de
Abstract
BACKGROUND:Patients with treatment-resistant major depressive disorder (MDD) remain a common clinical challenge.
METHODS:
This 6-week, randomised, open-label, rater-blinded trial evaluated once-daily extended-release quetiapine fumarate (quetiapine XR; 300 mg/day) as add-on to ongoing antidepressant and quetiapine XR monotherapy (300 mg/day) compared with add-on lithium (0.6-1.2 mmol/L) in patients with treatment-resistant MDD. Primary efficacy measure: change in Montgomery Åsberg Depression Rating Scale (MADRS) total score from randomisation to week 6 with a pre-specified non-inferiority limit of 3 points on the MADRS.
RESULTS:
At week 6, both add-on quetiapine XR (n=231) and quetiapine XR monotherapy (n=228) were non-inferior to add-on lithium (n=229); least squares means (LSM) differences (97.5% CI) in MADRS total score changes were -2.32 (-4.6, -0.05) and -0.97 (-3.24, 1.31), respectively. LSM MADRS total score change was numerically greater at day 4 for both quetiapine XR groups (add-on and monotherapy; p<0.01) compared with add-on lithium. At week 6, the differences between groups for the secondary endpoints of MADRS response (≥ 50% reduction in total score), MADRS remission (total score ≤ 10, add-on quetiapine XR only) and Clinical Global Impressions ('much'/'very much' improved) were numerically similar. Overall tolerability was consistent with the known profiles of both treatments.
LIMITATIONS:
Limitations included the open-label study design (although MADRS and laboratory measurements were performed by treatment-blinded raters) and relatively short study duration with no assessments in the continuation phase.
CONCLUSIONS:
Add-on quetiapine XR (300 mg/day) and quetiapine XR monotherapy (300 mg/day) are non-inferior to add-on lithium in the management of patients with treatment-resistant MDD.
© 2013 Published by Elsevier B.V.
KEYWORDS:Atypical antipsychotic, Augmentation, Lithium, Major depressive disorder, Quetiapine XR, Treatment-resistant depression
PMID: 23810357 [PubMed - in process]
poster:Phillipa
thread:1052947
URL: http://www.dr-bob.org/babble/20130930/msgs/1052947.html