Quetiapine Augmentation in Obsessive-Compulsive Disorder Resistant to Serotonin Reuptake Inhibitors

Quetiapine as an adjunctive pharmacotherapy for the treatment of non-remitting generalized anxiety disorder: A flexible-dose, open-label pilot trial

“…While this is the first study to extensively examine the efficacy of adjunctive quetiapine in GAD, the results support a recently published letter demonstrating the efficacy of quetiapine and risperidone monotherapy in the treatment of 36 patients with GAD or GAD with comorbid panic disorder (Galynker et al, 2005), along with previous publications that suggest that quetiapine is capable of reducing symptoms and improving quality of life in patients with a range of psychiatric disorders (Bogan et al, 2005;Brawman-Mintzer et al, 2006;Denys et al, 2004;Devarajan et al, 2006;Doree et al, 2004;Hamner et al, 2003;Schutters, Van Megen, & Westenberg, 2005;Yargic et al, 2004). The efficacy of antipsychotic augmentation of traditional therapies has been demonstrated in two small, double-blind, placebo-controlled studies of adjunctive olanzapine and risperidone (Brawman-Mintzer et al, 2005;McIntyre, Gendron, & McIntyre, 2007;Pollack et al, 2005).…”

“…The efficacy of augmentation therapy against anxiety and depressive symptoms in post-traumatic stress disorder, obsessivecompulsive disorder, and treatment-resistant depression has also been demonstrated with a range of atypical antipsychotics, including quetiapine (Bogan, Koran, Chuong, Vapnik, & Bystritsky, 2005;Denys, de Geus, Van Megen, & Westenberg, 2004;Devarajan, Ali, & Dursun, 2006;Doree et al, 2004;Hamner, Deitsch, Brodrick, Ulmer, & Lorberbaum, 2003;Yargic et al, 2004), aripiprazole (Worthington, Kinrys, Wygant, & Pollack, 2005), olanzapine (Bystritsky et al, 2004;Weiss, Potenza, McDougle, & Epperson, 1999) and risperidone (Li et al, 2005). Given that atypical antipsychotics have been shown to be an effective adjunctive treatment for anxiety and depression in such a diverse range of psychiatric conditions, it is not surprising that there is a growing interest in using these agents in the treatment of GAD.…”

Adjunctive quetiapine for serotonin reuptake inhibitor-resistant obsessive???compulsive disorder: a meta-analysis of randomized controlled treatment trials

“…The drug is reported to be associated with a favourable adverse effect profile compared with other second-generation antipsychotics, with reduced propensity for extrapyramidal side effects, prolactin and sexual dysfunction (Toren et al, 2004). Preliminary open-label studies showed benefits in up to 50% treated cases of OCD (Denys et al, 2002;Sevincok and Topuz, 2003;Bogan et al, 2005) although one study showed little benefit (Mohr et al, 2002). A single-blind study by Atmaca et al (2002) found a clinical response in 14 of 27 (64%) cases.…”

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

“…In long-term and relapse prevention studies, escitalopram, fluoxetine, paroxetine, sertraline and clomipramine were superior to placebo (see above for references). Within the limits of the acute treatment phase, response to treatment with SSRIs is characteristi- SSRI Pallanti et al 1999 Yes (C1) Addition of an SSRI to clomipramine Ravizza et al 1996 Yes (C1) Adding lithium to clomipramine * Rasmussen 1984 Yes (C1) Addition of buspirone to an* SSRI Jenike et al 1991b;Markovitz et al 1990 Yes (C1) Addition of topiramate to an SSRI Hollander and Dell'Osso, 2006;Van Ameringen et al 2006 Yes (C1) Addition of N-acetylcysteine to an SSRI Lafleur et al 2006 Yes (C2) Addition of atypical antipsychotics Á aripiprazole Á olanzapine, Á perospirone, Á quetiapine, or Á risperidone, to an SSRI or clomipramine Agid and Lerer 1999; Atmaca et al 2002;Bogan et al 2005;Bogetto et al 2000;da Rocha and Correa 2007;Dell'Osso et al 2006;Francobandiera, 2001;Friedman et al 2007b;Kawahara et al 2000;Koran et al 2000;Marazziti and Pallanti 1999;Marazziti et al 2005;Mohr et al 2002;Otsuka et al 2007;Pfanner et al 2000;Ravizza et al 1996;Saxena et al 1996;Stein et al 1997;Storch et al 2008;Weiss et al 1999;Yoshimura et al 2006 Yes (C1) cally partial. Between 30 and 60% cases in acute phase DBPC studies reached a clinically relevant level of improvement.…”