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.
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http://dx.doi.org/10.1186/1471-244X-8-73 | DOI Listing |
Bipolar depression is commonly accompanied by cognitive impairments. Transcranial direct current stimulation (tDCS) is emerging as a novel non-invasive treatment for bipolar depression. Given the portability and safety of tDCS, we developed a home-based protocol with real-time supervision.
View Article and Find Full Text PDFJAACAP Open
December 2024
University of Cincinnati College of Medicine, Cincinnati, Ohio.
Objective: To evaluate the efficacy of adjunctive topiramate (TPM) for the treatment of cannabis use disorder in adolescents with bipolar I disorder.
Method: We conducted a 16-week, double-blind, randomized, placebo-controlled investigation of quetiapine plus TPM (median dose = 208 mg) vs quetiapine plus placebo in adolescents with bipolar I and cannabis use disorder. All subjects participated in a Motivational Interview and Compliance Enhancement Therapy.
BMJ Open
November 2024
Department of Psychiatry and Behavioural Neurosciences, Hamilton, Stockholm, Sweden.
Objective: This study aims to conduct an overview on the comparative efficacy of valproate in acute mania, bipolar depression and maintenance treatment of bipolar disorder (BD).
Method: We performed an overview of systematic reviews with meta-analyses of randomised controlled trials (RCTs), registered in PROSPERO (CRD42024497749). We searched Medline and Cochrane Database of Systematic Reviews.
Psychiatry Res Commun
September 2024
Department of Clinical Neuroscience, Brighton and Sussex Medical School, University of Sussex, UK.
Patients with a diagnosis of Borderline Personality Disorder (BPD) often experience difficulties in psychosocial functioning, which reduces the ability of individuals to engage socially. This review seeks to determine whether atypical antipsychotics (AAPs) are more effective than placebo at alleviating these difficulties in adults with a diagnosis of BPD. We identified six Randomized Control Trials, conducted between 1994 and 2024, with 1012 patients that were treated with either: Olanzapine, Quetiapine, Ziprasidone or Aripiprazole.
View Article and Find Full Text PDFJ Affect Disord
January 2025
School of Psychology, University of East London, London, UK; Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK. Electronic address:
Aim: To investigate oscillatory networks in bipolar depression, effects of a home-based tDCS treatment protocol, and potential predictors of clinical response.
Methods: 20 participants (14 women) with bipolar disorder, mean age 50.75 ± 10.
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