Augmentative quetiapine in partial/nonresponders with generalized anxiety disorder: a randomized, placebo-controlled study

Int Clin Psychopharmacol. 2011 Jul;26(4):201-5. doi: 10.1097/YIC.0b013e3283457d73.

Abstract

Generalized anxiety disorder (GAD) is a chronic and disabling condition. The aim of this study was to evaluate the effectiveness of low-dose augmentative quetiapine (mean dose=50 mg/day) in patients with GAD and partial/no response to selective serotonin reuptake inhibitors (SSRIs). Twenty patients with GAD and partial/no response to SSRIs were randomized to quetiapine (n=10) or placebo (n=10) for 8 weeks, continuing their treatment with SSRIs. Analyses of variance with repeated measures on Hamilton Anxiety Rating Scale (HAM-A) and Clinical Global Impression (CGIs; severity of illness) were carried out at baseline and after 8 weeks and the number of responders/remitters was computed and compared between the groups. HAM-A scores at baseline were 15.60 (± 4.48) in the placebo group and 18.50 (± 6.59) in the quetiapine group, and at the end-point, HAM-A scores in the placebo group were 10.40 (± 4.88) and 9.20 (± 5.86) in the quetiapine group. A significant time-by-treatment effect was found on the HAM-A (F=5.19, P=0.035) and CGIs scores (F=19.60, P<0.001) in favor of the quetiapine group. The number of responders was numerically superior in the quetiapine group (60 vs. 30%) without reaching statistical significance (χ=1.82, degree of freedom=1, P=0.37, φ=0.30). Remitters were 40% for the quetiapine group versus 20% for the placebo group (χ=0.95, degree of freedom=1, P=0.63, φ=0.22). Low-dose augmentative quetiapine may be an useful treatment option for patients with GAD and partial/no response to SSRIs. The lack of double-blind conditions and the limited sample size may limit the confidence in the reported results. Larger randomized controlled trials are warranted to confirm these data.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / therapeutic use
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / drug therapy*
  • Dibenzothiazepines / administration & dosage
  • Dibenzothiazepines / therapeutic use*
  • Drug Therapy, Combination / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Quetiapine Fumarate
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Antipsychotic Agents
  • Dibenzothiazepines
  • Serotonin Uptake Inhibitors
  • Quetiapine Fumarate