Original scientific paper

QUETIAPINE AS COMBINATION TREATMENT WITH CITALOPRAM IN UNIPOLAR DEPRESSION WITH PROMINENT SOMATIC SYMPTOMS: A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED PILOT STUDY

Arnim Quante ; Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
Francesca Regen ; Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
Frank Schindler ; Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany, Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh Klinik, Berlin, Germany
Klaus Volkmer ; Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
Emanuel Severus ; Department of Psychiatry andPsychotherapy, Carl Gustav Carus University Hospital, Dresden, Germany
Carsten Urbanek ; Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
Alexander Luborzewski ; Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
Stefan Roepke ; Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
Ion Anghelescu ; Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany, Klinik Dr. Fontheim, Liebenburg, Germany

Abstract

Background: Patients with major depressive disorder (MDD) accompanied by physical symptoms may be less responsive to
antidepressant treatment. Quetiapine has been evaluated in the treatment of bipolar depression and has been recently approved as
an add-on therapy for unipolar depression. Less is known about the efficacy of combination therapies in patients suffering from
MDD with somatic symptoms. The aim of the present study was to evaluate the efficacy of quetiapine as adjunctive therapy to the
SSRI citalopram in patients with MDD and somatic complaints.
Subjects and methods: 41 inpatients with nonpsychotic DSM-IV MDD experiencing significant symptoms of somatic distress as
defined by a baseline score on the SCL-90-R somatization subscale greater one standard deviation above adult nonpatient norms
were randomly assigned to receive either citalopram 40 mg/day plus placebo (n=20) or citalopram 40 mg/day plus quetiapine, 300
to 600 mg/day (n=21) for 6 weeks. The primary outcome measure was the Hamilton Depression Rating Scale (HDRS) score.
Results: Mean changes in HDRS scores from baseline to week 6 using last-observation-carried-forward methods were -12.3±6.2
and -10.7±5.1 in the citalopram-quetiapine and citalopram-placebo group, respectively. Remission rates were significant higher in
the citalopram-quetiapine-group (41.1%) than in the citalopram-placebo-group (26.3%), respectively.
Conclusions: Although quetiapine as add-on to citalopram did not separate statistically from placebo on the HDRS score in
improving depressive symptoms and somatic symptoms in patients with MDD and prominent somatic complaints, higher remission
rates and other second outcome parameters showed advantages for quetiapine. Larger, double-blind, placebo-controlled trials of
quetiapine as augmentation therapy in MDD with somatic symptoms are warranted.

Keywords

antidepressants – citalopram - major depression – quetiapine - somatic symptoms

Hrčak ID:

161188

URI

https://hrcak.srce.hr/161188

Publication date:

17.9.2013.

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