Quetiapine in the Treatment of Psychotic Depression - a Pilot Study
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Purpose
Atypical antipsychotics have been found not only to be beneficial in the treatment of psychotic disorders, but even for depressive symptoms in patients with schizophrenia. Remarkably, preliminary data suggest that the atypical antipsychotic quetiapine has antidepressive properties. Until now, there is limited knowledge concerning the efficacy of quetiapine in major depressive illness and especially in psychotic depression. In our own clinical practice, several patients with psychotic depression were successfully treated with quetiapine as add-on therapy or as monotherapy. On the background of that, the convincing effects of quetiapine in bipolar depression, single-case reports and pilot studies concerning its effectiveness in depressive mood states in psychotic disorders as well as our clinical experiences, it is to assume that a treatment with quetiapine over a 6 weeks period show similar effects in major depressive episode with psychotic features, i.e. psychotic depression. In this pilot study we plan to investigate 20 patients with psychotic features of depression under treatment with quetiapine.
| Condition | Intervention | Phase |
|---|---|---|
|
Psychotic Depression |
Drug: Quetiapine |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Quetiapine in the Treatment of Psychotic Depression - a Pilot Study |
- MADRS [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
- Clinical laboratory evaluation [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
- Urinalysis [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
- ECG [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
- Physical and neurological examination [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
- Vital signs [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
| Enrollment: | 16 |
| Study Start Date: | September 2008 |
| Study Completion Date: | July 2012 |
| Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
-
Drug: Quetiapine
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- provision of written informed consent
- diagnosis of depression with psychotic features by DSM-IV (296.23, 296.33)
- females and males aged 18 to 65 years
- female patients of childbearing potential must be using a reliable method of contraception and have a negative pregnancy test at enrollment
- patients must be able to understand and comply with the requirements of the study
- MADRS score above 20 points
Exclusion Criteria:
- pregnancy or lactation
- any DSM-IV Axis I disorder not defined in the inclusion criteria or not in full remission
- patients who, in the opinion of the investigator, pose an imminent risk of suicide or a danger to self or others
- known intolerance or lack of response to quetiapine, as judged by the investigator
- use of any cytochrome P450 3A4 inhibitors in the 14 days preceding enrollment
- use of any cytochrome P450 inducers in the 14 days preceding enrollment
- thyroid-stimulating hormone (TSH) concentration more than 10% above the upper limit of the normal range at enrollment
- administration of a depot antipsychotic injection within one dosing interval before randomisation
- substance or alcohol dependence at enrollment, as defined by DSM-IV
- opiates, amphetamine, barbiturate, cocaine, cannabis, or hallucinogen abuse by DSM-IV criteria within 4 weeks prior to enrollment
- medical conditions that would affect absorption, distribution, metabolism, or excretion of study treatment
- risk of transmitting human immunodeficiency virus (HIV) or hepatitis B via blood or other body fluids
- unstable or inadequately treated medical illness, as judged by the investigator
- patients with diabetes mellitus (DM)
- an absolute neutrophil count (ANC) < 1.5x10E9 per liter
- history of idiopathic orthostatic hypotension, or condition that would predispose to
- ECG considered to show clinically significant abnormalities at enrollment as determined by a cardiologist
- involvement in the planning and conduct of the study
- previous enrollment or randomisation of treatment in the present study
- any serious and unstable somatic illness that, in the opinion of the investigator, would be negatively affects by the study medication
- participation in another drug trial within 4 weeks prior to enrollment into this study
- patients with unsufficient knowledge of the German language
Contacts and Locations| Germany | |
| LWL University Hospital Bochum of the Ruhr-University Bochum | |
| Bochum, NRW, Germany, 44791 | |
| Principal Investigator: | Georg Juckel, M.D., Ph.D. | LWL University Hospital Bochum |
More Information
Publications:
| Responsible Party: | PD Dr. Christine Norra, MD, PhD, Prof. Dr. med. Georg Juckel, LWL University Hospital Bochum, Ruhr University of Bochum |
| ClinicalTrials.gov Identifier: | NCT00751504 History of Changes |
| Other Study ID Numbers: | D1443L00040 |
| Study First Received: | September 11, 2008 |
| Last Updated: | January 23, 2013 |
| Health Authority: | Germany: Federal Institute for Drugs and Medical Devices |
Keywords provided by Ruhr University of Bochum:
|
Quetiapine Psychotic depression |
Additional relevant MeSH terms:
|
Depression Depressive Disorder Mental Disorders Psychotic Disorders Bipolar Disorder Depressive Disorder, Major Behavioral Symptoms Mood Disorders Schizophrenia and Disorders with Psychotic Features Affective Disorders, Psychotic |
Quetiapine Antipsychotic Agents Tranquilizing Agents Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Psychotropic Drugs |
ClinicalTrials.gov processed this record on May 16, 2013