The uses and outcomes of quetiapine in depressive and bipolar mood disorders in clinical practice.

We conducted an electronic chart review of a sample of all people attending secondary mental health care, in the county of Lanarkshire, Scotland, who were commenced on quetiapine for the following mood disorders: non-psychotic depression (n = 171), psychotic depression (n = 39), bipolar mania (n = 24), bipolar depression (n = 38) and bipolar mixed states (n = 31), between 2002 and 2007. We retrospectively assigned severity and improvement Clinical Global Impression (CGI) scores to measure effectiveness. Quetiapine was co-prescribed with antidepressants in 75-97% of depressive disorders. Commencing quetiapine was associated with clinical improvement in >64% of all patients, median doses (200-400 mg/day). For all depressive subtypes (non-psychotic, psychotic and bipolar) quetiapine was associated with improvement in 69% of patients. Across CGI measures, bipolar mania patients had the best outcome (89% improved). In bipolar mania, higher maximum doses were associated with greater improvement and 45% were continued on antidepressants. The results should be interpreted with caution due to the observational nature of the study and findings may not be attributed to the effects of quetiapine alone. Quetiapine was used mainly as an adjunct to other antidepressant and mood stabilising agents. The pharmacological profile of quetiapine suggests its properties extend beyond antipsychotic action, to antidepressant, anxiolytic and mood stabilising effects.