my personal edition > anxiety > news


  E-Mail this DGReview to a colleague

DGReview

Quetiapine Effective as Adjunct to Serotonin Reuptake Inhibitor Treatment

Quetiapine appears to be an effective adjunctive treatment for recalcitrant anxiety symptoms in individuals who are being treated with serotonin reuptake inhibitors (SSRIs) for either anxiety or depressive disorders.

SSRIs do not always adequately relieve symptoms in patients with comorbid anxiety. The atypical neuroleptic agent quetiapine has minimal extrapyramidal side effects and low potential for causing prolactin elevation or significant weight gain.

David E. Adson, MD, with the Department of Psychiatry, at the University of Minnesota, in Minneapolis, Minnesota, United States, and colleagues assessed the efficacy of quetiapine as adjunctive therapy to SSRIs for patients with anxiety symptoms complicating a depressive or anxiety disorder.

Patients receiving a stable dosage of an SSRI for at least 6 weeks who also had persistent anxiety symptoms (Hamilton Anxiety scale [HAM-A] of 16 or more), were enrolled in a 9-week, open-label, variable dose study.

The researchers assessed changes in clinical status with the Hamilton Depression Rating Scale (HAM-D), HAM-A, and State Anxiety Inventory (SAI).

By the second week of treatment, significant reductions of 50% or more in the HAM-D and HAM-A occurred in 10 of the 11 patients. Significant improvements were also seen in the SAI scale, and these improvements continued throughout the study.

"Addition of quetiapine to a stable dose of an SSRI resulted in a significant improvement of symptoms as measured by the primary outcome measures of depression and anxiety," Dr. Adson and colleague conclude.

Quetiapine was generally safe and well tolerated, and the adverse events were similar to those previously reported with quetiapine, the researchers note. The most frequent side effects reported were mild dry mouth, constipation, and transient drowsiness with dose escalation.

"The results of this study further support the safety and efficacy of atypical neuroleptics in augmenting the effects of antidepressants," they suggest. "Quetiapine may be a better tolerated agent than other atypicals for this purpose because of less potential for prolactin elevation, EPS, and weight gain," they add.



Depress Anxiety 2004;19:121-126. "Preliminary experience with adjunctive quetiapine in patients receiving selective serotonin reuptake inhibitors"

E-Mail this DGReview to a colleague

To print, use this version