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Pooled analysis of adjunct extended-release quetiapine fumarate in patients with major depressive disorder according to ongoing SSRI or SNRI treatment

Bauer, Michaela; Demyttenaere, Koenb; El-Khalili, Nizarc; Thase, Michael E.d; Papakostas, George I.e; Szamosi, Johanf; Earley, Willie R.g; Eriksson, Hansf

International Clinical Psychopharmacology:
doi: 10.1097/YIC.0000000000000011
Original Articles
Abstract

This pooled analysis evaluated the efficacy of extended-release quetiapine fumarate (quetiapine XR) adjunct to selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) in patients with major depressive disorder (MDD). Pooled data were analyzed from two 6-week, double-blind, randomized, placebo-controlled trials of adjunct quetiapine XR (150 and 300 mg/day) in patients with MDD and inadequate response to initial antidepressant monotherapy. This post-hoc analysis included evaluation of change from randomization at week 6 in Montgomery Åsberg Depression Rating Scale (MADRS) total scores (primary endpoint), and week 6 MADRS response and remission rates for quetiapine XR as an adjunct to ongoing SSRI or SNRI. In total, 189, 178, and 202 patients received quetiapine XR 150 mg/day+SSRI, 300 mg/day+SSRI, and placebo+SSRI, respectively, whereas 82, 90, and 76 patients, respectively, received quetiapine XR 150 mg/day+SNRI, 300 mg/day+SNRI, and placebo+SNRI. At week 6, quetiapine XR 150 mg/day+SSRI and 300 mg/day+SSRI reduced the MADRS total score from randomization versus placebo+SSRI [least squares mean (LSM) change, −14.70 (P<0.05) −14.72 (P<0.05) vs. –12.59, respectively]. Quetiapine XR 150 mg/day+SNRI (LSM change, –14.68, P<0.01) and 300 mg/day+SNRI (LSM change, –14.99, P<0.01) also reduced the MADRS total score from randomization at week 6 versus placebo+SNRI (−10.77). In conclusion, in patients with MDD and inadequate response to ongoing antidepressant, adjunct quetiapine XR (150 and 300 mg/day) was effective in both SSRI and SNRI subgroups.

Author Information

aDepartment of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany

bDepartment of Psychiatry, University Hospital Gasthuisberg, Leuven, Belgium

cAlpine Clinic, Lafayette, Illinois

dDepartment of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania

eDepartment of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

fFormer AstraZeneca R&D, Södertälje, Sweden

gFormer AstraZeneca Pharmaceuticals, Wilmington, Delaware, USA

Poster at the 164th Annual Meeting of the American Psychiatric Association, Honolulu, Hawaii, USA, 14–18 May 2011.

Poster at the 10th World Congress of Biological Psychiatry, Prague, Czech Republic, 29 May to 2 June 2011.

Poster at the 24th European College of Neuropsychopharmacology Congress, Paris, France, 3–7 September 2011.

Correspondence to Michael Bauer, MD, PhD, Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden D-01307, Germany Tel: +49 351 458 2772; fax: +49 351 458 4324; e-mail: michael.bauer@uniklinikum-dresden.de

Received November 1, 2012

Accepted September 5, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins