Evidence map›Paper›PMID 28651526›Full record

Trial reportBMC psychiatry2017

Study protocol for a randomised pragmatic trial comparing the clinical and cost effectiveness of lithium and quetiapine augmentation in treatment resistant depression (the LQD study).

L Marwood, R Taylor, K Goldsmith, R Romeo, R Holland, A Pickles, J Hutchinson, D Dietch, A Cipriani, R Nair and 5 more

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IVComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03004521 (A Randomised Pragmatic Trial Comparing the Clinical and Cost Effectiveness of Lithium and Quetiapine Augmentation in Treatment Resistant Depression), which is not on this map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03004521 phase4unknown statusnot on this map

A Randomised Pragmatic Trial Comparing the Clinical and Cost Effectiveness of Lithium and Quetiapine Augmentation in Treatment Resistant Depression

TypeinterventionalSponsorKing's College LondonRan2016 to 2021Enrolled276ConditionsDepressive Disorder, Treatment-ResistantArmsQuetiapine, Lithium
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pharmacological Augmentation in Unipolar Depression: A Guide to the Guidelines.The international journal of neuropsychopharmacology · 2020
    Pooled it
  2. Pharmacological interventions for treatment-resistant depression in adults.The Cochrane database of systematic reviews · 2019
    Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

L MarwoodCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. lindsey.marwood@kcl.ac.uk.ORCID 0000-0002-5818-2199
R TaylorCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
K GoldsmithBiostatistics & Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
R RomeoHealth Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
R HollandBiostatistics & Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
A PicklesBiostatistics & Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
J HutchinsonNorthumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
D DietchLonsdale Medical Centre, London, UK.
A CiprianiDepartment of Psychiatry, University of Oxford, Oxford, UK.
R NairTees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK.
M-J AttenburrowDepartment of Psychiatry, University of Oxford, Oxford, UK.
A H YoungCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
J GeddesDepartment of Psychiatry, University of Oxford, Oxford, UK.
R H McAllister-WilliamsNorthumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
A J CleareCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
King's College London · GBOxford Health NHS Foundation Trust · GBCumbria Northumberland Tyne and Wear NHS Foundation Trust · GBTees, Esk and Wear Valleys NHS Foundation Trust · GB

Funding

Department of Health HTA/14/222/02Wellcome Trust
6 · The paper itself

Abstract

backgroundApproximately 30-50% of patients with major depressive disorder can be classed as treatment resistant, widely defined as a failure to respond to two or more adequate trials of antidepressants in the current episode. Treatment resistant depression is associated with a poorer prognosis and higher mortality rates. One treatment option is to augment an existing antidepressant with a second agent. Lithium and the atypical antipsychotic quetiapine are two such add-on therapies and are currently recommended as first line options for treatment resistant depression. However, whilst neither treatment has been established as superior to the other in short-term studies, they have yet to be compared head-to-head in longer term studies, or with a superiority design in this patient group.

methodsThe Lithium versus Quetiapine in Depression (LQD) study is a parallel group, multi-centre, pragmatic, open-label, patient randomised clinical trial designed to address this gap in knowledge. The study will compare the clinical and cost effectiveness of the decision to prescribe lithium or quetiapine add-on therapy to antidepressant medication for patients with treatment resistant depression. Patients will be randomised 1:1 and followed up over 12 months, with the hypothesis being that quetiapine will be superior to lithium. The primary outcomes will be: (1) time to all-cause treatment discontinuation over one year, and (2) self-rated depression symptoms rated weekly for one year via the Quick Inventory of Depressive Symptomatology. Other outcomes will include between group differences in response and remission rates, quality of life, social functioning, cost-effectiveness and the frequency of serious adverse events and side effects. DISCUSSION: The trial aims to help shape the treatment pathway for patients with treatment resistant depression, by determining whether the decision to prescribe quetiapine is superior to lithium. Strengths of the study include its pragmatic superiority design, broad inclusion criteria (external validity) and longer follow up than previous studies.

trial registrationISRCTN registry: ISRCTN16387615 , registered 28 February 2016. ClinicalTrials.gov: NCT03004521 , registered 17 November 2016.

Indexed as

Cost-Benefit AnalysisAdultAntidepressive AgentsAntipsychotic AgentsDepressive Disorder, Treatment-ResistantDrug Therapy, CombinationHumansLithiumMajor Depressive DisorderQuetiapine FumarateAntidepressive AgentsAntipsychotic AgentsLithiumQuetiapine FumarateAugmentationLithiumLongitudinalMulti-centreOpen-labelPragmaticQuetiapineRandomised clinical trialSuperiority designTreatment resistant depression

Identifiers

PMID28651526
PMCPMC5485607
OpenAlexW2622827696

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.