| Quetiapine augmentation in obsessive-compulsive disorder resistant to serotonin reuptake inhibitors: an open-label study. | |
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MedLine Citation:
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PMID: 15669891 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The response of obsessive-compulsive disorder (OCD) to serotonin reuptake inhibitors (SRIs) is often inadequate. Case series reporting successful augmentation with risperidone and olanzapine led us to investigate quetiapine in OCD that was resistant to SRI treatment. METHOD: In this 8-week, 2-site (S1, S2), open-label trial, 30 adults (16 at S1 and 14 at S2) with a DSM-IV diagnosis of OCD, SRI-resistant, received augmentation with quetiapine, with the dose doubled every 2 weeks from 25 mg to 200 mg/day. Primary outcome was measured with the Yale-Brown Obsessive Compulsive Scale (YBOCS). A response was defined as a > or = 25% decrease from the baseline YBOCS score. RESULTS: Significant differences between the sites in patient characteristics (7/14 at S2 were hoarders, i.e., more treatment resistant, vs. 1/16 at S1; p = .01) and in quetiapine treatment (mean +/- SD dose of 116 +/- 72 mg/day at S2 vs. 169 +/- 57 mg/day at S1; p = .039) necessitated separate analysis of results. At S1, the mean +/- SD YBOCS score fell significantly from 27.7 +/- 7.0 to 23.3 +/- 8.4 (t = 2.96, df = 15, p = .01), and the responder rate was 31% (5/16). At S2, the mean YBOCS score did not decrease significantly, and the responder rate was 14% (2/14). Most adverse medication events were mild or moderate. Two subjects (13%) at S1 and 3 (21%) at S2 withdrew due to adverse events. CONCLUSION: The results at S1 resemble those reported with other atypical antipsychotics and suggest that quetiapine augmentation may benefit treatment-resistant OCD. The poorer results at S2 may reflect the large proportion of hoarders or the less intense treatment. Longer, higher dose, large, double-blind, placebo-controlled comparison trials of atypical antipsychotics are needed. |
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Authors:
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Ann M Bogan; Lorrin M Koran; Helen W Chuong; Tanya Vapnik; Alexander Bystritsky |
Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of clinical psychiatry Volume: 66 ISSN: 0160-6689 ISO Abbreviation: J Clin Psychiatry Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2005-01-26 Completed Date: 2005-02-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7801243 Medline TA: J Clin Psychiatry Country: United States |
Other Details:
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Languages: eng Pagination: 73-9 Citation Subset: IM |
Affiliation:
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Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA 94305, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antipsychotic Agents
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therapeutic use* Anxiety Disorders / epidemiology Comorbidity Depressive Disorder, Major / epidemiology Dibenzothiazepines / therapeutic use* Dose-Response Relationship, Drug Drug Administration Schedule Drug Resistance Drug Therapy, Combination Humans Obsessive-Compulsive Disorder / drug therapy*, epidemiology, psychology Psychiatric Status Rating Scales Serotonin Uptake Inhibitors / therapeutic use* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antipsychotic Agents; 0/Dibenzothiazepines; 0/Serotonin Uptake Inhibitors; 0/quetiapine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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