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Wang G, McIntyre A, Earley WR, et al. A randomized, double-blind study of the efficacy and tolerability of extended-release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder. Neuropsychiatr Dis Treat. 2014;10:201-16doi: 10.2147/NDT.S50248.
Wang, G., McIntyre, A., Earley, W. R., Raines, S. R., & Eriksson, H. (2014). A randomized, double-blind study of the efficacy and tolerability of extended-release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder. Neuropsychiatric disease and treatment, 10201-16. https://doi.org/10.2147/NDT.S50248
Wang, Gang, et al. "A randomized, double-blind study of the efficacy and tolerability of extended-release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder." Neuropsychiatric disease and treatment vol. 10 (2014): 201-16. doi: https://doi.org/10.2147/NDT.S50248
Wang G, McIntyre A, Earley WR, Raines SR, Eriksson H. A randomized, double-blind study of the efficacy and tolerability of extended-release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder. Neuropsychiatr Dis Treat. 2014 Jan 30;10:201-16. doi: 10.2147/NDT.S50248. eCollection 2014. PMID: 24511235; PMCID: PMC3916085.
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Neuropsychiatr Dis Treat. 2014 Jan 30;10:201-16. doi: 10.2147/NDT.S50248. eCollection 2014.

A randomized, double-blind study of the efficacy and tolerability of extended-release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder.

Neuropsychiatric disease and treatment

Gang Wang, Alexander McIntyre, Willie R Earley, Shane R Raines, Hans Eriksson

Affiliations

  1. Beijing Anding Hospital, Capital Medical University, Beijing, People's Republic of China.
  2. Department of Psychiatry, Penticton Regional Hospital, Penticton, BC, Canada.
  3. AstraZeneca Pharmaceuticals, Wilmington, DE, USA.
  4. AstraZeneca R&D, Södertälje, Sweden.

PMID: 24511235 PMCID: PMC3916085 DOI: 10.2147/NDT.S50248

Abstract

OBJECTIVES: To evaluate the efficacy and tolerability of once-daily extended release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder (MDD).

PATIENTS AND METHODS: This was a 10-week (8-week active treatment/2-week post-treatment) randomized, double-blind, placebo- and active-controlled study (D1448C00004). Patients received quetiapine XR 150 mg/day, escitalopram 10 mg/day, or placebo; patients with an inadequate response (<20% improvement in Montgomery-Åsberg Depression Rating Scale [MADRS] total score) at week two received double-dose treatment. The primary end point was week eight change from randomization in MADRS total score. Secondary end points included MADRS response (≥50% improvement) and remission (score ≤8); Hamilton Rating Scale for Depression total and item 1; Hamilton Rating Scale for Anxiety total, psychic, and somatic; Clinical Global Impressions - Severity of Illness total; Pittsburgh Sleep Quality Index (PSQI) global; and Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form percentage maximum total scores. Tolerability was assessed throughout.

RESULTS: A total of 471 patients was randomized. No significant improvements in MADRS total score were observed at week eight (last observation carried forward) with either active treatment (quetiapine XR, -17.21 [P=0.174]; escitalopram, -16.73 [P=0.346]) versus placebo (-15.61). There were no significant differences in secondary end points versus placebo, with the exception of week-eight change in PSQI global score (quetiapine XR, -4.96 [P<0.01] versus placebo, -3.37). Mixed-model repeated-measures analysis of observed-case data suggested that the primary analysis may not be robust. Most commonly reported adverse events included dry mouth, somnolence, and dizziness for quetiapine XR, and headache and nausea for escitalopram.

CONCLUSION: In this study, neither quetiapine XR (150/300 mg/day) nor escitalopram (10/20 mg/day) showed significant separation from placebo. Both compounds have been shown previously to be effective in the treatment of MDD; possible reasons for this failed study are discussed. Quetiapine XR was generally well tolerated, with a profile similar to that reported previously.

Keywords: Phase III; antidepressive agents (pharmacological action); antipsychotic agents; clinical trial; sustained-release preparations; treatment efficacy

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