Extended release quetiapine fumarate as adjunct to antidepressant therapy in patients with major depressive disorder: pooled analyses of data in patients with anxious depression versus low levels of anxiety at baseline

Bandelow, Borwin; Bauer, Michael; Vieta, Eduard; El-Khalili, Nizar; Gustafsson, U.; Earley, Willie; Eriksson, Hans

doi:10.3109/15622975.2013.842654

Cited by 16 publications

(10 citation statements)

References 60 publications

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“…Although monotherapy with antidepressant treatments (ADTs) can be effective in treating MDD with anxiety symptoms, patients may be less likely to experience sustained response or remission (Ionescu et al., ). Subgroup analyses of short‐term, larger studies have indicated that augmentation with an antipsychotic is an effective strategy in the treatment of MDD with anxiety symptoms (Bandelow et al., ; Trivedi et al., ). Pooled analysis from two double‐blind, placebo‐controlled studies in patients with MDD and inadequate response to ADTs demonstrated that augmentation with aripiprazole improved Montgomery–Åsberg Depression Rating Scale (MADRS) total score in a subgroup with baseline Hamilton Rating Scale for Depression (HAM‐D) anxiety/somatization factor score ≥ 7 (Trivedi et al., ).…”

Section: Introductionmentioning

confidence: 99%

“…Pooled analysis from two double‐blind, placebo‐controlled studies in patients with MDD and inadequate response to ADTs demonstrated that augmentation with aripiprazole improved Montgomery–Åsberg Depression Rating Scale (MADRS) total score in a subgroup with baseline Hamilton Rating Scale for Depression (HAM‐D) anxiety/somatization factor score ≥ 7 (Trivedi et al., ). Quetiapine extended‐release (XR) augmentation has also been reported to improve MADRS total score in subgroups of patients with MDD and inadequate response to ADTs, with anxious depression defined as baseline HAM‐D anxiety/somatization factor score ≥ 7, and alternatively as baseline Hamilton Rating Scale for Anxiety (HAM‐A) ≥ 20 (Bandelow et al., ).…”

Section: Introductionmentioning

confidence: 99%

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Adjunctive brexpiprazole in patients with major depressive disorder and anxiety symptoms: an exploratory study

et al. 2016

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BackgroundMajor depressive disorder (MDD) with concurrent anxiety symptoms may signal a difficult‐to‐treat patient. Brexpiprazole is a serotonin–dopamine activity modulator: a partial agonist at 5‐HT1A and dopamine D2 receptors at similar potency, and an antagonist at 5‐HT2A and noradrenaline alpha1B/2C receptors. The objective of this Phase IIIb study was to explore effectiveness, safety, and tolerability of brexpiprazole adjunctive to antidepressant (ADT) monotherapy in patients with MDD and anxiety symptoms (NCT02013531).MethodsPatients with MDD, Hamilton Anxiety Rating Scale (HAM‐A) total score ≥ 20, and inadequate response to current ADT received open‐label brexpiprazole 1–3 mg day−1 (target dose 2 mg day−1) + ADT for 6 weeks. Efficacy endpoints included change from baseline at Week 6 in Montgomery–Åsberg Depression Rating Scale (MADRS) total score, HAM‐A total score, and Sheehan Disability Scale (SDS). Safety and tolerability assessments included adverse events (AEs).ResultsOf 37 participants enrolled, 32 (86.5%) completed the study. Baseline mean (SD) MADRS total score was 30.1 (5.1); mean HAM‐A total score was 26.9 (5.0). Improvements from baseline were observed at Week 6 for least squares mean change in MADRS total score (−19.6, p < .0001 vs. baseline), HAM‐A total score (−17.8, p < .0001) and mean (SD) SDS mean score [−3.6 (2.6)]. Brexpiprazole was well tolerated. The most frequent treatment‐emergent AEs were increased appetite (13.5%) and diarrhea, dry mouth, and dizziness (all 10.8%).ConclusionsThese open‐label results support the anxiolytic effects of adjunctive brexpiprazole in the treatment of patients with MDD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adjunctive brexpiprazole in patients with major depressive disorder and anxiety symptoms: an exploratory study

et al. 2016

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“…Previously, pooled data from two adjunctive quetiapine trials did find significant antidepressant efficacy for quetiapine versus placebo in patients with anxious depression (with a mean difference in reduction in Montgomery-Asberg Depression Rating Scale (MADRS) scores in patients treated with 150mg or 300mg of adjunctive quetiapine versus placebo of 2.6 and 3.3, respectively). (Bandelow et al, 2014) Interestingly enough, however, equivalent differences in efficacy for patients with low levels of anxiety in those two trials were not in the clinically significant range (1.7 versus 1.2 for 150mg and 300mg, respectively). Equivalent differences in changes in HAM-A scores for these two populations were 1.65 and 2.03 (in favor of quetiapine 150mg and 300mg, respectively, p <0.05) versus 1 and 0.8 (in favor of quetiapine 150mg and 300mg, respectively, p >0.05).…”

Section: Discussionmentioning

confidence: 90%

Ziprasidone augmentation for anxious depression

Ionescu

Shelton²,

Baer³

et al. 2016

International Clinical Psychopharmacology

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Previously, we found an anxiolytic effect of ziprasidone augmentation to escitalopram (compared to placebo augmentation) in patients with depression in an 8-week, randomized, double-blind, parallel-group, placebo-controlled trial. Here, we conducted a post-hoc analysis, comparing changes in the Hamilton Depression (HDRS) and Anxiety (HAM-A) rating scales between patients with anxious depression versus nonanxious depression, using a moderator analysis. HDRS total change scores from baseline and endpoint were not significantly different (interaction term p=0.91) in patients with anxious depression on ziprasidone augmentation (n=19; −9.1 ± 4.9) or placebo (n=19; −6.1 ± 8.9) versus patients without anxious depression on ziprasidone (n=52; −5.5 ± 6.7) or placebo (n=49; −2.3 ± 4.5). There was a trend towards statistical significance (interaction term p=0.1) in favor of patients without anxious depression for a difference in HAM-A total change scores from baseline to endpoint (patients with anxious depression on ziprasidone augmentation (n=19; −2.7 ± 5.3) or placebo (n=19; −3.3 ± 5.8) versus patients without anxious depression on ziprasidone (n=51; −3.9 ± 6.6) or placebo (n=44; −0.9 ± 4.7)). Ziprasidone augmentation was equally efficacious in treating depression in patients with versus without anxious depression. However, the observed anxiolytic effect for patients with higher anxiety was not clinically significant.

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“…Studies focussing on clinical or biological characteristics of subtypes of depression most often compared one subtype of depression with patients not exhibiting this subtype (Bandelow et al, ; Baune et al, ; Harkness & Monroe, ; Kaestner et al, ; Liu et al, ; Monzon et al, ; Papakostas, Fan, & Tedeschini, ; Paslakis et al, ; Pizzagalli et al, ; Quinn, Rennie, Harris, & Kemp, ; Seppala et al, ; Zaninotto et al, ). However, such approaches do not account for the underlying heterogeneity, since other subtypes were disregarded in dichotomous approaches.…”

Section: Introductionmentioning

confidence: 99%

Subtypes of depression and their overlap in a naturalistic inpatient sample of major depressive disorder

Musil

Seemüller

Meyer

et al. 2017

Int J Methods Psych Res

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Subtyping depression is important in order to further delineate biological causes of depressive syndromes. The aim of this study was to evaluate clinical and outcome characteristics of distinct subtypes of depression and to assess proportion and features of patients fulfilling criteria for more than one subtype. Melancholic, atypical and anxious subtypes of depression were assessed in a naturalistic sample of 833 inpatients using DSM-IV specifiers based on operationalized criteria. Baseline characteristics and outcome criteria at discharge were compared between distinct subtypes and their overlap. A substantial proportion of patients (16%) were classified with more than one subtype of depression, 28% were of the distinct anxious, 7% of the distinct atypical and 5% of the distinct melancholic subtype. Distinct melancholic patients had shortest duration of episode, highest baseline depression severity, but were more often early improvers; distinct anxious patients had higher NEO-Five Factor Inventory (NEO-FFI) neuroticism scores compared with patients with unspecific subtype. Melancholic patients with overlap of anxious features had worse treatment outcome compared to distinct melancholic and distinct anxious subtype. Distinct subtypes differed in only few variables and patients with overlap of depression subtypes may have independent clinical and outcome characteristics. Studies investigating biological causes of subtypes of depression should take influence of features of other subtypes into account.

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Extended release quetiapine fumarate as adjunct to antidepressant therapy in patients with major depressive disorder: pooled analyses of data in patients with anxious depression versus low levels of anxiety at baseline

Abstract: Adjunct quetiapine XR demonstrates efficacy in patients with anxious and non-anxious depression, assessed using HAM-A total score, and anxious depression assessed using HAM-D anxiety/somatisation factor score.

Cited by 16 publications

References 60 publications

Adjunctive brexpiprazole in patients with major depressive disorder and anxiety symptoms: an exploratory study

Adjunctive brexpiprazole in patients with major depressive disorder and anxiety symptoms: an exploratory study

Ziprasidone augmentation for anxious depression

Subtypes of depression and their overlap in a naturalistic inpatient sample of major depressive disorder

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