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Quetiapine Addition to Serotonin Reuptake Inhibitors in Patients With Severe Obsessive-Compulsive Disorder: A Double-Blind, Randomized, Placebo-Controlled Study

Kordon, Andreas MD*; Wahl, Karina PhD*; Koch, Nicole*; Zurowski, Bartosz MD*; Anlauf, Matthias MD*; Vielhaber, Kirsten MD; Kahl, Kai G. PhD, MD*; Broocks, Andreas PhD, MD; Voderholzer, Ulrich PhD, MD; Hohagen, Fritz PhD, MD*

Journal of Clinical Psychopharmacology: October 2008 - Volume 28 - Issue 5 - p 550-554
doi: 10.1097/JCP.0b013e318185e735
Brief Reports

Objective: Although many patients with obsessive-compulsive disorder (OCD) benefit from treatment with serotonin reuptake inhibitors (SRIs), it is estimated that 40% to 60% of them do not respond. The objective of the present study was to evaluate the efficacy of quetiapine added to baseline treatment with SRIs for the treatment of OCD in severely ill adult subjects.

Method: Forty patients (21 men, 19 women) with primary OCD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria participated in a 12-week, double-blind, placebo-controlled trial. They were randomly assigned to dosages of quetiapine titrated up to 400 mg/d (n = 20) or to placebo (n = 20) in addition to their SRI treatment. During the continuation phase (weeks 6-12), subjects received different dosages between 400 and 600 mg/d depending on clinical response. At entry, all patients were unresponsive to at least 1 course of at least 12 weeks of treatment with SRIs at defined doses. The total Yale-Brown Obsessive-Compulsive Scale score was the primary efficacy parameter.

Results: Intention-to-treat, last-observation-carried-forward analysis demonstrated a mean ± SD decrease in Yale-Brown Obsessive-Compulsive Scale score of 5.2 ± 5.4 in the quetiapine group and 3.9 ± 4.9 in the placebo group. The analysis of treatment effects between the 2 groups showed no significant difference. There were no significant group differences in any of the other self-rating scales or clinician-administered rating scales.

Conclusions: In this study, augmentation of SRI treatment with quetiapine in severe OCD had no additional effect.

*Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck; †Department of Psychiatry and Psychosomatic, University of Freiburg Medical School, Freiburg, Germany; and ‡Department of Psychiatry and Psychotherapy, HELIOS Kliniken Schwerin, Schwerin, Germany.

Received July 23, 2007; accepted after revision July 7, 2008.

Drs Kordon and Wahl contributed equally.

This study was supported by an investigator-initiated research grant and drugs provided by AstraZeneca Pharmaceuticals.

Address correspondence and reprint requests to Andreas Kordon, MD, Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.