Quetiapine augmentation of antidepressant treatment in elderly patients suffering from depressive symptoms: A retrospective chart review

Depression in elderly patients is often characterized by poor responses to standard antidepressants. Several reports have suggested that quetiapine also may have antidepressant properties. The present study aimed to evaluate the efficacy of quetiapine augmentation in depressed elderly patients previously unresponsive to a full course of treatment. Medical charts of elderly depressed inpatients treated at a tertiary care psychiatric center during a 3-year period were reviewed. Clinical and demographic data were extracted from computerized records and analyzed. The primary outcome measure was the change on the clinical global impressions scale for improvement (CGI-I). Twenty depressed elderly inpatients received quetiapine augmentation during the study period. Prior to augmentation all had been treated with antidepressants. Baseline mean severity of depression was 6.40; severity after augmentation was significantly reduced to 3.25; the change in CGI-I was 2.10 (p< 0.03). Mean quetiapine dose was 70. mg; mean duration of augmentation was 3.9 weeks. Five patients complained of somnolence. One patient discontinued psycho-tropics and switched to electroconvulsive therapy (ECT) due to life-threatening suicidal tendencies. We tentatively conclude that quetiapine augmentation for elderly depressed patients unresponsive to standard antidepressant treatment may be a safe and efficacious option. Further prospective studies need be carried out to support our observation.