Adjunctive quetiapine for serotonin reuptake inhibitor-resistant obsessive-compulsive disorder: a meta-analysis of randomized controlled treatment trials.
Small studies have shown positive effects from adding a variety of antipsychotic agents in patients with obsessive-compulsive disorder who are unresponsive to treatment with serotonin reuptake inhibitors. The evidence, however, is contradictory. This paper reports a meta-analysis of existing double-blind randomized placebo-controlled studies looking at the addition of the second-generation antipsychotic quetiapine in such cases. Three studies fulfilled the inclusion criteria. Altogether 102 individuals were subjected to analysis using Review Manager (4.2.7). The results showed evidence of efficacy for adjunctive quetiapine (<400 mg/day) on the primary efficacy criterion, measured as changes from baseline in total Yale-Brown Obsessive Compulsive Scale scores (P=0.008), the clinical significance of which was limited by between-study heterogeneity. The mechanism underlying the effect may involve serotonin and/or dopamine neurotransmission.
Fineberg
Naomi A
NA
Hertfordshire Partnership NHS Trust, UK. naomi.fineberg@btinternet.com
Stein
Dan J
DJ
Premkumar
Preethi
P
Carey
Paul
P
Sivakumaran
Thanusha
T
Vythilingum
Bavanisha
B
Seedat
Soraya
S
Westenberg
Herman
H
Denys
Damiaan
D
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D000069348:Quetiapine Fumarate; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate; D017367:Selective Serotonin Reuptake Inhibitors