A randomised pragmatic trial comparing the clinical and cost effectiveness of lithium and quetiapine augmentation in treatment resistant depression.

Record ID 32016000804
Authors' objectives: There is currently uncertainty about how best to treat patients whose depression has not shown a good response to initial antidepressant treatments ( treatment resistant depression TRD). This is a major problem as perhaps half of patients do not respond fully to antidepressants alone. There are several effective options for treating TRD, including medication or psychological therapies. However, few good studies have compared these treatments directly with one another. Furthermore, most studies have been short-term (i.e. 6-8 weeks) and have not assessed the longer-term effects of these treatments. This is a problem because, not only do patients with TRD experience a longer and more difficult condition to treat in the first place, they also have higher rates of relapse in the 12 months or so after responding. Thus, it is not enough to look only at the short term effects. A common option for patients and their doctor is to prescribe a different type of medication in addition to an antidepressant ( augmentation, or add-on treatment). For many years, lithium has been a standard first line add-on treatment. We now know that some newer antipsychotics are also effective add-on treatments for TRD, usually in doses lower than those used for psychosis. One of these, the extended release version of quetiapine, is now licenced for TRD in the UK. We propose to compare the long term effects of lithium and quetiapine head to head over 12 months to see which medication is most clinically and cost-effective for patients with TRD.
Project Status: Ongoing
Anticipated Publish Date: 2021
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Lithium Compounds
  • Antipsychotic Agents
  • Cost-Benefit Analysis
  • Depressive Disorder, Treatment-Resistant
  • Dibenzothiazepines
  • Antidepressive Agents
  • Quetiapine Fumarate
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: Queen's Printer and Controller of HMSO
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