![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
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]
Posted by Christ_empowered on October 24, 2013, at 19:02:04
In reply to Quintiapine XR Mono or Lithium Add on to add's MDD, posted by Phillipa on October 24, 2013, at 18:35:38
I think I'd take Seroquel @ 300 over Lithium, as long as I could pop antioxidants to combat potential TD. Seems safer.
Posted by Phillipa on October 24, 2013, at 20:32:45
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD, posted by Christ_empowered on October 24, 2013, at 19:02:04
In honesty I don't know as wanted to see what others thought of this study. Thanks for answering Phillipa
Posted by Fiat500 on October 25, 2013, at 1:54:41
In reply to Quintiapine XR Mono or Lithium Add on to add's MDD, posted by Phillipa on October 24, 2013, at 18:35:38
I am embarrassed to say I don't understand this study. Are they saying seroquel and lithium are good together? Can't make sense of it.
Posted by Phillipa on October 25, 2013, at 18:35:08
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD » Phillipa, posted by Fiat500 on October 25, 2013, at 1:54:41
Posted for informational purposes only. I thought you guys could let me know? Kinda funny!!!
Posted by doxogenic boy on October 26, 2013, at 9:21:21
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD » Phillipa, posted by Fiat500 on October 25, 2013, at 1:54:41
> I am embarrassed to say I don't understand this study. Are they saying seroquel and lithium are good together? Can't make sense of it.
For me it seems like quetiapine XR as add-on to antidepressants and quetiapine XR as monotherapy are just as good as lithium as add-on to antidepressants.
http://www.ncbi.nlm.nih.gov/pubmed/23810357Lithium just made me stable in my depression.
- doxogenic
Posted by Christ_empowered on October 26, 2013, at 16:02:39
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD » Fiat500, posted by doxogenic boy on October 26, 2013, at 9:21:21
yeah, I've heard lithium does that, which is why I'm always so confused as to why docs use it for unipolar MDD. Seems like you'd want to lift your patients up a bit, not slow them down, right? Hmmm...
Anyway, I was skeptical of AAPs for depression at first (I have to take a full dose of Abilify for craziness), but it seems like a lot of people respond quite well, especially to zyprexa and Seroquel.
For me, I can see it happening, because Abilify may not really help depression on its own very much, but it doesn't make depression worse, which was a problem with Depakote, klonopin, and Risperdal for me. So, I cam see how with low doses and/or an AD on board, it could help depression.
Posted by doxogenic boy on October 26, 2013, at 16:38:29
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD, posted by Christ_empowered on October 26, 2013, at 16:02:39
> yeah, I've heard lithium does that, which is why I'm always so confused as to why docs use it for unipolar MDD. Seems like you'd want to lift your patients up a bit, not slow them down, right? Hmmm...
Yes; I hated lithium for this. When I discontinued it, I became better soon. I tried low-dose lithium many years later, but that didn't work for depression either.
> Anyway, I was skeptical of AAPs for depression at first (I have to take a full dose of Abilify for craziness), but it seems like a lot of people respond quite well, especially to zyprexa and Seroquel.
I was skeptical to both old and atypical antipsychotics after bad experinces with perphenazine, chlorpromazine and risperiodone. But when I searched for medication for treatment-resistant depression seven years ago, I found an article about Seroquel helping for TRD, and then I asked my psychiatrist to try it as add-on to my antidepressants. I am still satisfied with Seroquel.
- doxogenic
Posted by Fiat500 on October 26, 2013, at 21:43:39
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD » Fiat500, posted by Phillipa on October 25, 2013, at 18:35:08
That is so funny! I was looking to you the nurse!
Posted by Fiat500 on October 26, 2013, at 21:46:49
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD » Fiat500, posted by doxogenic boy on October 26, 2013, at 9:21:21
Thanks for clearing that up. I am on the IR version not the XR version. Did lithium help your depression or did it just stabilize an already depressed mood? I am going to ask my doctor about it but I am worried about weight gain.
Posted by Fiat500 on October 26, 2013, at 21:48:39
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD » Christ_empowered, posted by doxogenic boy on October 26, 2013, at 16:38:29
Should have read your response first you have answered my question thank you.
Posted by Phillipa on October 26, 2013, at 22:27:38
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD » Phillipa, posted by Fiat500 on October 26, 2013, at 21:43:39
It arrived in my RN newsletter but doesn't mean I'd understand. Used to have drug reps explain this stuff or the docs worked with also. Now it's me , google and you guys!!!! Phillipa
Posted by doxogenic boy on October 28, 2013, at 8:38:04
In reply to Re: Quintiapine XR Mono or Lithium Add on to add's MDD » doxogenic boy, posted by Fiat500 on October 26, 2013, at 21:48:39
Thank your for your response.
- doxogenic
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.