title: A randomized, double-blind, and placebo-controlled trial of quetiapine augmentation of fluoxetine in major depressive disorder.
abstract: The objective of this study was to investigate whether quetiapine, when compared with placebo, can speed the onset of action and improve the quality of response to fluoxetine treatment in patients suffering from major depressive disorder. A total of 114 patients with major depressive disorder were enrolled in an 8-week treatment study. Patients were initiated on a course of fluoxetine treatment and randomized to quetiapine or placebo. Quetiapine was flexibly dosed starting at 25 mg to a maximum of 100 mg daily. Mixed-effects regression showed that quetiapine plus fluoxetine did not achieve 50% reduction in the Montgomery-Asberg Depression Rating Scale score or improvement in Hamilton Anxiety Scale, Clinical Global Improvement (CGI)-Severity, and CGI-Improvement scores sooner than the fluoxetine plus placebo group; however both groups improved in all scores over time. Mixed-effects linear regression of insomnia scores showed that the quetiapine plus fluoxetine group improved significantly more rapidly compared with the fluoxetine plus placebo group. The study indicates that quetiapine plus fluoxetine did not achieve a reduction in the Montgomery-Asberg Depression Rating Scale score or improvement in Hamilton Anxiety Scale or CGI scores from baseline sooner than the fluoxetine plus placebo group. The combination of quetiapine and fluoxetine, however, improved sleep over fluoxetine alone over the first few weeks of treatment.
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, New York 10075, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Garakani
authors.forename: Jose M
authors.initials: JM
authors.lastname: Martinez
authors.forename: Sue
authors.initials: S
authors.lastname: Marcus
authors.forename: James
authors.initials: J
authors.lastname: Weaver
authors.forename: Karl
authors.initials: K
authors.lastname: Rickels
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
authors.forename: Jack
authors.initials: J
authors.lastname: Hirschowitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D000069348:Quetiapine Fumarate; D012044:Regression Analysis; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D005473:Fluoxetine; D000069348:Quetiapine Fumarate