Add-on Quetiapine for Difficult to Treat Bipolar Depression

Background: “Difficult to treat depression” includes depression that inherently does not respond satisfactorily to one or more treatments that are optimally delivered. Quetiapine is effective for treatment for bipolar depression but its use in “difficult to treat bipolar depression” is yet to be explored. Objectives: To evaluate the effectiveness of quetiapine in “difficult to treat bipolar depression”, as add on agent with mood stabilizers. Methods: Seven patients who had “difficult to treat depression” were treated with add on quetiapine to usual treatment and response to treatment was assessed. Results: Depression improved in all patients after add on quetiapine and maintained improvement for an average duration of follow-up of eleven months. Quetiapine was generally well tolerated without any significant side effects. Conclusions: The addition of quetiapine to usual treatment improves difficult to treat depression in bipolar disorder and is generally safe and well tolerated (German J Psychiatry 2010; 13: 41-44).