Clinical and cost-effectiveness of lithium versus quetiapine augmentation for treatment-resistant depression in adults:LQD a pragmatic randomised controlled trial
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| Název: | Clinical and cost-effectiveness of lithium versus quetiapine augmentation for treatment-resistant depression in adults:LQD a pragmatic randomised controlled trial |
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| Zdroj: | 2025, 'Clinical and cost-effectiveness of lithium versus quetiapine augmentation for treatment-resistant depression in adults : LQD a pragmatic randomised controlled trial', Health technology assessment (Winchester, England), vol. 29, no. 12, pp. 1-118. https://doi.org/10.3310/YQVF5347 |
| Rok vydání: | 2025 |
| Sbírka: | University of Bristol: Bristol Reserach |
| Témata: | Humans, Quetiapine Fumarate/therapeutic use, Cost-Benefit Analysis, Female, Male, Middle Aged, Depressive Disorder, Treatment-Resistant/drug therapy, Adult, Antipsychotic Agents/therapeutic use, Antidepressive Agents/therapeutic use, Drug Therapy, Combination, Quality-Adjusted Life Years, Aged, England, Lithium/therapeutic use |
| Popis: | BACKGROUND: Lithium and several atypical antipsychotics are the recommended first-line augmentation options for treatment-resistant depression; however, few studies have compared them directly, and none for longer than 8 weeks. Consequently, there is little evidence-based guidance for clinicians when choosing an augmentation option for patients with treatment-resistant depression. OBJECTIVES: This trial examined whether it is more clinically and cost-effective to prescribe lithium or quetiapine augmentation therapy for patients with treatment-resistant depression over 12 months. DESIGN: This was a parallel group, multicentre, pragmatic, open-label superiority trial comparing the clinical and cost-effectiveness of lithium versus quetiapine augmentation of antidepressant medication in treatment-resistant depression. Participants were randomised 1 : 1 at baseline to the decision to prescribe either lithium or quetiapine. SETTING: Six National Health Service trusts in England. PARTICIPANTS: Eligible participants were aged ≥ 18 years, met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for major depressive disorder, scored ≥ 14 on the 17-item Hamilton Depression Rating Scale and whose depression had had an inadequate response to at least two therapeutic antidepressant treatment trials in the current episode, with a current antidepressant treatment at or above the therapeutic dose for ≥ 6 weeks. Patients with a history of psychosis or bipolar disorder were excluded. Patients were judged suitable for either treatment. INTERVENTIONS: After randomisation, pre-prescribing safety checks were undertaken as per standard care and trial clinicians decided whether to proceed with prescribing the allocated medication. Trial clinicians received recommendations for titration and dosing in line with current clinical guidelines; however, dosing regimens could be altered according to tolerability and response. Participants were followed up using weekly self-report questionnaires and 8-, 26- and 52-week ... |
| Druh dokumentu: | article in journal/newspaper |
| Jazyk: | English |
| DOI: | 10.3310/YQVF5347 |
| Dostupnost: | https://hdl.handle.net/1983/c8db7026-224f-43a2-89a0-4a7f73692846 https://research-information.bris.ac.uk/en/publications/c8db7026-224f-43a2-89a0-4a7f73692846 https://doi.org/10.3310/YQVF5347 |
| Rights: | info:eu-repo/semantics/openAccess |
| Přístupové číslo: | edsbas.2D8595EE |
| Databáze: | BASE |
Nájsť tento článok vo Web of Science | Abstrakt: | BACKGROUND: Lithium and several atypical antipsychotics are the recommended first-line augmentation options for treatment-resistant depression; however, few studies have compared them directly, and none for longer than 8 weeks. Consequently, there is little evidence-based guidance for clinicians when choosing an augmentation option for patients with treatment-resistant depression. OBJECTIVES: This trial examined whether it is more clinically and cost-effective to prescribe lithium or quetiapine augmentation therapy for patients with treatment-resistant depression over 12 months. DESIGN: This was a parallel group, multicentre, pragmatic, open-label superiority trial comparing the clinical and cost-effectiveness of lithium versus quetiapine augmentation of antidepressant medication in treatment-resistant depression. Participants were randomised 1 : 1 at baseline to the decision to prescribe either lithium or quetiapine. SETTING: Six National Health Service trusts in England. PARTICIPANTS: Eligible participants were aged ≥ 18 years, met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for major depressive disorder, scored ≥ 14 on the 17-item Hamilton Depression Rating Scale and whose depression had had an inadequate response to at least two therapeutic antidepressant treatment trials in the current episode, with a current antidepressant treatment at or above the therapeutic dose for ≥ 6 weeks. Patients with a history of psychosis or bipolar disorder were excluded. Patients were judged suitable for either treatment. INTERVENTIONS: After randomisation, pre-prescribing safety checks were undertaken as per standard care and trial clinicians decided whether to proceed with prescribing the allocated medication. Trial clinicians received recommendations for titration and dosing in line with current clinical guidelines; however, dosing regimens could be altered according to tolerability and response. Participants were followed up using weekly self-report questionnaires and 8-, 26- and 52-week ... |
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| DOI: | 10.3310/YQVF5347 |