Objective. Fibromyalgia and major depressive disorder (MDD) frequently co-occur. Quetiapine fumarate extended-release (quetiapine XR) has demonstrated efficacy in the treatment of MDD and has been shown to have analgesic properties in patients with depression. The primary objectives of this study were to evaluate the effects of quetiapine XR on depressive and pain symptoms in patients with MDD and comorbid fibromyalgia, and to assess its safety and tolerability. Results. The mean change in the HAM-D score from baseline to week 8 was significantly greater in the quetiapine XR group compared with the placebo group (؊10.0 versus ؊5.8; P ؍ 0.001). Improvements in most secondary outcomes were also significantly greater in the quetiapine XR group. Quetiapine XR was generally well tolerated.Conclusion. This study is the first to demonstrate that measures of depression, pain, and quality of life are significantly improved with quetiapine XR compared with placebo in patients with a dual diagnosis of MDD and fibromyalgia.Fibromyalgia is a syndrome characterized by widespread musculoskeletal pain that lasts at least 3 months, with a reduced pain threshold. Widespread pain is the defining feature of fibromyalgia. Associated symptoms include fatigue, sleep disturbance, stiffness, cognitive symptoms, and mood abnormalities including depression and anxiety (1,2). Pain, fatigue, and sleep disturbance are present in at least 75% of patients (3). The condition is estimated to occur in ϳ2-4% of the general adult population (4,5), and the prevalence is higher among women (4.9%) than men (1.6%) (6).Patients with fibromyalgia are at increased risk of mood disorders. Studies suggest that the prevalence of current depression among patients with fibromyalgia is as high as 22-40% (7), and that lifetime prevalence rates reach 58-86% (8,9). This high degree of co-occurrence is thought to be related in part to pathophysiologic abnormalities that are shared between fibroClinicalTrials.gov identifier: NCT00675896.