Quetiapine(QUE) augmentation of selective serotonin reuptake inhibitors (SSRIs) on initial phase for drugfree obsessive-compulsive disorder(OCD):about dropout

Abstract

Abstract: AIM: To evaluate the impact of quetiapine augmentation of selective serotonin reuptake inhibitors (SSRIs) on dropout in drugfree obsessive-compulsive disorder(OCD) patients in real practice. METHODS: 146 drugfree OCD patients who were prescribed SSRIs either alone or with quetiapine on initial phase were investigated retrospectively about dropout and relevant information. Dropout was defined as treatment interruption prior to the end of the first 12 week treatment period. Symptom Checklist-90 (SCL-90) were assessed on baseline. Chisquare and Mann-Whitney tests were used to compare the difference between dropouts and completers. Prediction of dropout was conducted using logistic regression analysis. Variables with a P value<0.05 with respect to the difference between dropouts and completers in this initial analysis were included in the logistic regression analysis where dropout was the response variable. RESULTS: The patients who were prescribed SSRIs+QUE on initial phase were less likely to drop out than those who were prescribed only SSRIs(dropout rates, 40% vs 70.4%,χ²=9.37,P<0.01). According to the result of the logistic regression analysis, the initial prescription type(P<0.01)and the severity of pretreatment OCD symptoms(P<0.01) were significantly associated with the probability of dropout. CONCLUSION: SSRIs+QUE therapy on initial phase could decrease the dropout from treatment for drugfree OCD patients, which meant OCD patients would have more chance to benefit from continuing treatment .

Key words: Obsessive-compulsive disorder, Dropout, Quetiapine, Treatment

CLC Number:

R749

WANG Ji-hui, WU Xiao-li, GAN Zhao-yu, WEN Sheng-lin. Quetiapine(QUE) augmentation of selective serotonin reuptake inhibitors (SSRIs) on initial phase for drugfree obsessive-compulsive disorder(OCD):about dropout[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(9): 1042-1047.

References

[1] Ruscio AM, Stein DJ, Chiu WT,et al.The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication[J]. Mol Psychiatry,2010,15(1):53-63.
[2] Kessler RC, Chiu WT, Demler O, et al.Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication[J]. Arch Gen Psychiatry,2005,62(6):617-627.
[3] Ackerman DL, Greenland S.Multivariate meta-analysis of controlled drug studies for obsessive-compulsive disorder[J]. J Clin Psychopharmacol, 2002,22(3):309-317.
[4] Koran LM, Hanna GL, Hollander E,et al.Practice guideline for the treatment of patients with obsessive-compulsive disorder[J]. Am J Psychiatry,2007,164(7 Suppl):5-53.
[5] Khan A, Schwartz K.Psychiatric diagnosis and clinical trial completion rates: analysis of the FDA SBA reports[J]. Neuropsychopharmacology, 2007,32(11):2422-2430.
[6] Belotto-Silva C, Diniz JB, Malavazzi DM,et al.Group cognitive-behavioral therapy versus selective serotonin reuptake inhibitors for obsessive-compulsive disorder: a practical clinical trial[J]. J Anxiety Disord, 2012,26(1):25-31.
[7] Bloch MH, Landeros-Weisenberger A, Kelmendi B,et al.A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder[J]. Mol Psychiatry, 2006,11(7):622-632.
[8] 夏金校,姚华华,王一冰,等.艾司西酞普兰联合小剂量阿立哌唑治疗伴躯体症状抑郁症的研究[J].中国临床药理学与治疗学,2011,61(8):929-932.
[9] Dell'Osso B, Mundo E, Altamura AC.Quetiapine augmentation of selective serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a six-month follow-up case series[J]. CNS Spectr, 2006,11(11):879-883.
[10] Denys D, Fineberg N, Carey PD, et al.Quetiapine addition in obsessive-compulsive disorder: is treatment outcome affected by type and dose of serotonin reuptake inhibitors[J]? Biol Psychiatry, 2007,61(3):412-414.
[11] 陈树林,李凌江.SCL-90信度效度检验和常模的再比较[J].中国神经精神疾病杂志,2003,29(5):323-327.
[12] Walsh KH, McDougle CJ. Psychotherapy and medication management strategies for obsessive-compulsive disorder[J]. Neuropsychiatr Dis Treat, 2011,7:485-494.
[13] Diniz JB, Malavazzi DM, Fossaluza V, et al.Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder[J]. Clinics (Sao Paulo), 2011,66(3):387-393.
[14] Warden D, Trivedi MH, Wisniewski SR,et al.Early adverse events and attrition in selective serotonin reuptake inhibitor treatment: a suicide assessment methodology study report[J]. J Clin Psychopharmacol, 2010,30(3):259-266.
[15] Baune BT.New developments in the management of major depressive disorder and generalized anxiety disorder: role of quetiapine[J]. Neuropsychiatr Dis Treat, 2008,4(6):1181-1191.
[16] Vulink NC, Denys D, Fluitman SB,et al.Quetiapine augments the effect of citalopram in non-refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled study of 76 patients[J]. J Clin Psychiatry, 2009,70(7):1001-1008.
[17] Mancebo MC, Pinto A, Rasmussen SA,et al.Development of the Treatment Adherence Survey-patient version (TAS-P) for OCD[J]. J Anxiety Disord,2008,22(1):32-43.
[18] Aderka IM, Anholt GE, van Balkom AJ,et al. Differences between early and late drop-outs from treatment for obsessive-compulsive disorder[J].J Anxiety Disord, 2011,25(7):918-923.