A double-blind, randomized, placebo-controlled trial of quetiapine addition in patients with obsessive-compulsive disorder refractory to serotonin reuptake inhibitors
Abstract
Background Although serotonin reuptake inhibitors (SRIs) are the most effective pharmacologic treatment currently available for patients with obsessive-compulsive disorder (OCD), 40% to 60% of patients do not respond to this treatment. This study was conducted to evaluate the efficacy and tolerability of quetiapine in addition to an SRI for treatment-refractory patients with OCD. Method Forty patients (10 men/30 women, mean +/- SD age = 35.2 +/- 12.1 years; range, 18-60 years) with primary OCD according to DSM-IV criteria who were recruited between February 2001 and December 2002 were randomly assigned in an 8-week, double-blind, placebo-controlled trial to receive dosages titrated upward to 300 mg/day of quetiapine (N = 20) or placebo (N = 20) in addition to their SRI treatment. At entry, all patients were unresponsive to courses of treatment with at least 2 different SRIs at a maximum tolerated dose for 8 weeks. During the study, primary efficacy was assessed according to change from baseline on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). A responder was defined as having a final Clinical Global Impressions-Improvement scale rating of "very much improved" or "much improved" and a decrease of > or = 35% in Y-BOCS score. Results An intent-to-treat, last-observation-carried-forward analysis demonstrated a mean +/- SD decrease in Y-BOCS score of 9.0 +/- 7.0 (31%) in the quetiapine group and 1.8 +/- 3.4 (7%) in the placebo group (F=16.99, df=1,38; p Conclusion The result…
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An estimated 40-60% of OCD patients do not respond to SSRI treatment and require additional treatment with atypical antipsychotics, which affects both the serotonergic and dopaminergic system.
“Nevertheless, an estimated 40–60% of patients does not respond to this treatment and require additional treatment with atypical antipsychotics, which affects both the serotonergic and dopaminergic system (Denys et al., 2004a; Fineberg et al., 2005).”
From Response Inhibition and Interference Control in Obsessive–Compulsive Spectrum Disorders (2014) · cites this paper as Denys et al., 2004a
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- Authors
- Denys, D., de Geus, F., van Megen, H. J. G. M., & Westenberg, H. G. M.
- Affiliations
- University Medical Center Utrecht (NL)
- ORCID
- Denys, Damiaan
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2004-08-15
- Volume
- 65
- Issue
- 8
- Pages
- 1040
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W1987671737
- Cited by
- 248
- References
- 0
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 7 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 4 · 2019: 11 · 2018: 6 · 2017: 6 · 2016: 5 · 2015: 14 · 2014: 14 · 2013: 7 · 2012: 44
- FWCI
- 21.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- quetiapine, obsessive-compulsive disorder, treatment-refractory OCD, serotonin reuptake inhibitors, adjunctive therapy, atypical antipsychotics, Yale-Brown Obsessive Compulsive Scale, treatment response, tolerability, sleepiness, weight gain, dizziness, xerostomia, psychopharmacological treatment, clinical global impression
- MeSH terms
- Quetiapine Fumarate, Adolescent, Adult, Ambulatory Care, Dibenzothiazepines, Dizziness, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Placebos, Psychiatric Status Rating Scales, Sleep, Antipsychotic Agents, Xerostomia, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Diagnostic and Statistical Manual of Mental Disorders
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