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Open Access Highly Accessed Research article

The co-administration of quetiapine or placebo to cognitive-behavior therapy in treatment refractory depression: A preliminary trial

Yves Chaput125*, Annick Magnan3 and Alain Gendron4

Author Affiliations

1 Associate Professor of Psychiatry, McGill University Montreal, Quebec, Canada

2 Assistant Professor of Psychiatry, University of Montreal, Montreal, Quebec, Canada

3 "Centre de Psychologie René Laënnec", 1100, Beaumont Ave, Montreal, Quebec, H3P 3H5, Canada

4 Neurosciences, Medical Affairs, AstraZeneca Canada Mississauga, Ontario, Canada

5 Current address: 365 rue Normand, suite 230, Saint-Jean-sur-Richelieu, Quebec, J3A 1T6, Canada

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BMC Psychiatry 2008, 8:73  doi:10.1186/1471-244X-8-73

Published: 28 August 2008

Abstract

Background

Patients with major depression refractory to repeated pharmacological trials (TRD) may remain symptomatic for many years after their index episode. Augmentation strategies (with lithium or an atypical antipsychotic) or combining an antidepressant with short-term psychotherapy have been used with relative success in these patients. The aim of this study was to assess the effectiveness of the concomitant administration of quetiapine, an atypical antipsychotic, or placebo, to cognitive-behavior therapy (CBT) in TRD.

Methods

Thirty-one patients who met entrance criteria for unipolar major depression (TRD stage II or greater) underwent 3 weeks of lithium augmentation after which non-responders (N = 22) were randomized to receive either quetiapine or placebo as an adjunct to their 12 weekly CBT sessions (quetiapine/CBT or placebo/CBT groups). Primary efficacy measures were the Hamilton and the Montgomery-Asberg rating scales for depression.

Results

Overall, there was a significant reduction in both primary efficacy measure scores at LOCF for the 11 patients in the quetiapine/CBT group but not in the placebo/CBT treated patients. Patients in the quetiapine/CBT group, compared to those receiving placebo/CBT, showed a significantly greater degree of improvement on one primary and one secondary efficacy measure, were more likely to complete the trial and, completed a greater number of CBT sessions.

Conclusion

Although preliminary, our results suggest that the adjunctive administration of quetiapine to CBT may prove useful in the treatment of stage II TRD.

Trial Registration

Current Controlled Trials ISRCTN12638696.