Extended Release Quetiapine Fumarate in Major Depressive Disorder: Analysis in Patients With Anxious Depression

Thase, Michael E.; Demyttenaere, Koen; Earley, Willie; Gustafsson, U.; Udd, Mattias; Eriksson, Margaretha

doi:10.1002/da.21970

Cited by 34 publications

(17 citation statements)

References 37 publications

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“…In contrast to the many psychopharmacologic treatment studies that have evaluated adult patients with “anxious depression,” 80–83 pediatric studies have largely focused on patients with depression or anxiety (eg, social phobia, separation anxiety disorder, GAD, or the combination) and have generally excluded anxious patients with comorbid MDD. 84–88 Abundant evidence suggests that selective serotonin reuptake inhibitors (SSRIs) are effective in treating both pediatric MDD and anxiety disorders, 89–91 and, on the basis of randomized controlled trials of SSRIs and selective serotonin norepinephrine reuptake inhibitors (SNRIs) (Table 1), recommendations can be extrapolated regarding the treatment of anxious depression in pediatric patients.…”

Section: Psychopharmacologic Treatment Of Anxious-depression In Youthmentioning

confidence: 99%

“…It is interesting that post-hoc analyses of trials with both aripiprazole and quetiapine have suggested that these agents may have efficacy for anxious depression. 83,131 However, use of second-generation antipsychotic medications has been associated with significant adverse effects, including weight gain, diabetes or insulin insensitivity, dyslipidemia, and potential tardive dyskinesia. Thus, the risk and benefits of any medication changes should be weighed to ensure optimal therapeutic outcomes.…”

Section: Psychopharmacologic Treatment Of Anxious-depression In Youthmentioning

confidence: 99%

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Comorbid Anxiety and Depressive Symptoms in Children and Adolescents

Melton

Croarkin

Strawn

et al. 2016

Journal of Psychiatric Practice

140

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Background. A large and extensive body of research has examined comorbid anxiety and depression in adults. Children and adolescents also frequently present with comorbid anxiety and depression; however, research and treatment require unique environmental and neurodevelopmental considerations in children. As a result, our understanding of comorbid anxiety and depression in children and adolescents is limited. Objective. The goal of this systematic review was to examine current literature focused on comorbid anxiety and depression in children and adolescents. The review included theoretical conceptualizations as well as diagnostic, neurobiologic, prevention, and treatment considerations. In addition, a proposed algorithm for the treatment of comorbid anxiety and depression in children/adolescents is provided. Methods. This systematic literature review included three discrete searches in Ovid SP Medline, PsychInfo, and Pubmed. Results. The review included and synthesized 115 articles published between 1987 and 2015. The available evidence suggests that anxiety and depression are common in clinical populations of children and adolescents, and that comorbidity is likely underestimated in children and adolescents. Children and adolescents with comorbid anxiety and depression have unique presentations, greater symptom severity, and treatment resistance compared with those who have either disease in isolation. A dimensional approach may be necessary for the future development of diagnostic strategies and treatments for this population. Nascent neuroimaging work suggests that anxiety and depression each represents a distinct neurobiological phenotype. Conclusion. The literature that is currently available suggests that comorbid anxiety and depression is a common presentation in children and adolescents. This diagnostic picture underscores the importance of comprehensive dimensional assessments and multimodal evidence-based approaches given high disease severity. Future research on the neurobiology and treatment of these common clinical conditions is warranted.

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Section: Psychopharmacologic Treatment Of Anxious-depression In Youthmentioning

confidence: 99%

Section: Psychopharmacologic Treatment Of Anxious-depression In Youthmentioning

confidence: 99%

Comorbid Anxiety and Depressive Symptoms in Children and Adolescents

Melton

Croarkin

Strawn

et al. 2016

Journal of Psychiatric Practice

140

View full text Add to dashboard Cite

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“…Symptom severity, clinical course/outcome and functioning may be worse in patients with atypical/anxious depression than in those without [43,44]. According to retrospective analyses of pooled data of aripiprazole and quetiapine XR, they may be effective and reliable augmentation agents for patients with MDD regardless of the presentation of subdepressive symptoms, depression severity, past treatment response, or previous antidepressant treatment failure [45][46][47][48][49]. No clinical factors predicting response to augmentation antipsychotics have been found in patients with MDD.…”

Section: Clinical Issues In the Use Of Atypical Antipsychotics In CLImentioning

confidence: 99%

Clinical Issues in Use of Atypical Antipsychotics for Depressed Patients

Pae

Patkar

2013

CNS Drugs

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Major depressive disorder (MDD) is a chronic, recurrent mental disease that causes serious disability. Because currently available antidepressants have limited efficacy with respect to response and remission in patients with MDD, clinicians must choose the best available treatment interventions for patients who do not respond to initial antidepressant treatment. The existing literature demonstrates that augmentation with atypical antipsychotics (AAs) shows higher response and remission rates compared with antidepressant monotherapy, but is associated with more withdrawals due to adverse events. In this paper, specific clinical issues in the use of AA augmentation for patients with MDD are briefly discussed. Given the limited information and clinical knowledge on the proper and effective use of AAs for MDD, future research should focus on practical clinical issues that can be commonly seen in routine practice but have not been addressed yet. This is because the use of AAs is likely to expand as there is good evidence for their effectiveness and tolerability as augmentation therapy for patients with MDD.

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“…(Ionescu et al, 2014) Although treatment with serotonergic antidepressants (e.g., selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs)) can result in initial treatment success in some cases, patients with anxious depression can often require second- and third-line therapy in order to achieve sustained response or remission. (Ionescu et al, 2014, Wiethoff et al, 2010, Wu et al, 2013a) Furthermore, anxious depression puts patients at a higher risk than those without anxious depression for suicidal thinking and attempts (Fava et al, 2008, Seo et al, 2011) and side-effects,(Ionescu et al, 2014, Chan et al, 2012, Thase et al, 2012, Farabaugh et al, 2012, Fava et al, 2008, Wu et al, 2013b) which contribute to overall poorer treatment outcomes. (Ionescu et al, 2014, Farabaugh et al, 2012, Fava et al, 2008, Wiethoff et al, 2010, Wu et al, 2013b, Thase et al, 2012)…”

Section: Introductionmentioning

confidence: 99%

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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Extended Release Quetiapine Fumarate in Major Depressive Disorder: Analysis in Patients With Anxious Depression

Abstract: Quetiapine XR monotherapy improved symptoms of depression in patients with higher and lower levels of anxiety.

Cited by 34 publications

References 37 publications

Comorbid Anxiety and Depressive Symptoms in Children and Adolescents

Comorbid Anxiety and Depressive Symptoms in Children and Adolescents

Clinical Issues in Use of Atypical Antipsychotics for Depressed Patients

Ziprasidone augmentation for anxious depression

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