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Re: Extended Release Seroquel Approved For Depression

Posted by SLS on December 12, 2009, at 5:20:52

In reply to Extended Release Seroquel Approved For Depression, posted by Phillipa on December 8, 2009, at 20:19:59

> FDA Approves Extended-Release Quetiapine as Add-On Treatment of Depression

It looks like AstraZeneca got lucky on this one. I think they acted early enough to give the appearance that their drug is somehow more antidepressant-like than the other atypical antipsychotics. That's not to say that Seroquel is without beneficial effect when treating depression for a subset of people. However, the same claim could be made for the other atypical antipsychotics. Perhaps it is the 5-HT2a antagonism that these drugs share that is most important in their antidepressant effect. Abilify was the first of these drugs to be approved for antidepressant augmentation. However, there are differences between these drugs, too. One must consider that Seroquel has a major metabolite that is a norepinephrine reuptake inhibitor; a property that some classic antidepressants share.

Seroquel made me feel irritable and perhaps slightly dysphoric. However, I watched someone experience an energizing antidepressant effect within two hours of adding Seroquel to her treatment regime. Her diagnosis is questionable, though. It is difficult to place her with respect to polarity. She did experience major depressive episodes, but psychotic mixed states were more prominent. Since the introduction of Seorquel, she has been stable, productive, and employed.

I think the problem with touting Seroquel as an antidepressant augmenter is one of perspective. I'm sure it can act as one, but under what circumstances does one introduce it in treatment? What is the percentage of people that it helps? Are there certain case profiles for which it is best suited? What is the risk versus benefit of using Seroquel for depression?


- Scott

 

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poster:SLS thread:928562
URL: http://www.dr-bob.org/babble/20091206/msgs/928962.html