Patient perspectives of lithium and quetiapine augmentation treatment in treatment-resistant depression: A qualitative assessment.
Treatment-resistant depression
major depressive disorder
pharmacotherapy
qualitative
thematic
Journal
Journal of psychopharmacology (Oxford, England)
ISSN: 1461-7285
Titre abrégé: J Psychopharmacol
Pays: United States
ID NLM: 8907828
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
pubmed:
28
4
2022
medline:
18
5
2022
entrez:
27
4
2022
Statut:
ppublish
Résumé
Treatment-resistant depression (TRD) has a profound cost to patients and healthcare services worldwide. Pharmacological augmentation is one therapeutic option for TRD, with lithium and quetiapine currently recommended as first-line agents. Patient opinions about pharmacological augmentation may affect treatment outcomes, yet these have not been systematically explored. This study aimed to qualitatively assess patient experiences of lithium and quetiapine augmentation. Semi-structured interviews were conducted with 32 patients from the ongoing lithium versus quetiapine open-label trial comparing these augmentation agents in patients with TRD. Interviews were audio recorded, transcribed and a thematic analysis was used to assess patient opinions of each agent. Four main themes were generated from the thematic analysis: 'Initial concerns', 'Experience of side effects', 'Perception of treatment efficacy' and 'Positive perception of treatment monitoring'. Patient accounts indicated a predominantly positive experience of lithium and quetiapine augmentation. Greater apprehension about side effects was reported for lithium prior to treatment initiation, but greater experience of negative side effects was reported for quetiapine. Clinical monitoring was perceived positively. Patient accounts suggested treatment augmentation with lithium or quetiapine was acceptable and helpful for most patients. However, anticipation and experiences of adverse side effects may prevent some patients from benefitting from these treatments.
Sections du résumé
BACKGROUND
Treatment-resistant depression (TRD) has a profound cost to patients and healthcare services worldwide. Pharmacological augmentation is one therapeutic option for TRD, with lithium and quetiapine currently recommended as first-line agents. Patient opinions about pharmacological augmentation may affect treatment outcomes, yet these have not been systematically explored.
AIMS
This study aimed to qualitatively assess patient experiences of lithium and quetiapine augmentation.
METHODS
Semi-structured interviews were conducted with 32 patients from the ongoing lithium versus quetiapine open-label trial comparing these augmentation agents in patients with TRD. Interviews were audio recorded, transcribed and a thematic analysis was used to assess patient opinions of each agent.
RESULTS
Four main themes were generated from the thematic analysis: 'Initial concerns', 'Experience of side effects', 'Perception of treatment efficacy' and 'Positive perception of treatment monitoring'. Patient accounts indicated a predominantly positive experience of lithium and quetiapine augmentation. Greater apprehension about side effects was reported for lithium prior to treatment initiation, but greater experience of negative side effects was reported for quetiapine. Clinical monitoring was perceived positively.
CONCLUSION
Patient accounts suggested treatment augmentation with lithium or quetiapine was acceptable and helpful for most patients. However, anticipation and experiences of adverse side effects may prevent some patients from benefitting from these treatments.
Identifiants
pubmed: 35475375
doi: 10.1177/02698811221089042
pmc: PMC9112618
doi:
Substances chimiques
Antidepressive Agents
0
Antipsychotic Agents
0
Quetiapine Fumarate
2S3PL1B6UJ
Lithium
9FN79X2M3F
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
557-565Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Références
BJPsych Open. 2021 May 14;7(3):e101
pubmed: 33988121
J Psychopharmacol. 2018 Apr;32(4):408-415
pubmed: 29552933
BMJ Open. 2019 Jun 12;9(6):e031110
pubmed: 31196907
Soc Forces. 2005 Dec;84(2):1273-1289
pubmed: 16534533
Curr Med Res Opin. 2007 Feb;23(2):333-41
pubmed: 17288688
J Manag Care Spec Pharm. 2019 Jul;25(7):823-835
pubmed: 31232205
J Clin Psychiatry. 2009 Apr;70(4):540-9
pubmed: 19358791
J Clin Psychiatry. 2021 Sep 28;82(5):
pubmed: 34587377
J Psychopharmacol. 2015 May;29(5):459-525
pubmed: 25969470
Am J Psychiatry. 2006 Sep;163(9):1519-30; quiz 1665
pubmed: 16946176
Sleep Med Clin. 2015 Mar;10(1):17-23
pubmed: 26055669
Pharmaceuticals (Basel). 2020 Jun 04;13(6):
pubmed: 32512768
Int J Neuropsychopharmacol. 2020 Dec 3;23(9):587-625
pubmed: 32402075
Qual Saf Health Care. 2002 Jun;11(2):148-52
pubmed: 12448807
J Affect Disord. 1990 Dec;20(4):217-23
pubmed: 2149727
J Psychopharmacol. 1994 Jan;8(4):266-7
pubmed: 22298635
J Psychopharmacol. 2019 Feb;33(2):167-176
pubmed: 30698058
Int J Neuropsychopharmacol. 2010 Aug;13(7):917-32
pubmed: 20175941
Front Psychol. 2017 Feb 21;8:233
pubmed: 28270786
J Affect Disord. 2013 Oct;151(1):209-19
pubmed: 23810357
Psychother Psychosom. 2011;80(1):39-47
pubmed: 20975325
J Affect Disord. 2018 Oct 1;238:674-679
pubmed: 29966932
Behav Res Ther. 2010 Jul;48(7):614-25
pubmed: 20399418
BMC Psychiatry. 2017 Jun 26;17(1):231
pubmed: 28651526
Crit Care Med. 2009 Jan;37(1 Suppl):S140-6
pubmed: 19104214
Br J Psychiatry. 2007 Feb;190:172-3
pubmed: 17267936
J Affect Disord. 2014 Sep;166:334-42
pubmed: 25012450
J Affect Disord. 2009 Sep;117(1-2):116-9
pubmed: 19171384
BMJ. 1998 Apr 18;316(7139):1230-2
pubmed: 9583929
Br J Psychiatry. 2019 Jan;214(1):42-51
pubmed: 30457075
Br J Psychiatry. 1991 Oct;159:510-4
pubmed: 1836411
J Clin Psychiatry. 2009 Feb;70(2):177-84
pubmed: 19192471
BMC Psychiatry. 2018 Apr 11;18(1):100
pubmed: 29642877
Health Technol Assess. 2011 May;15(20):1-234, iii-iv
pubmed: 21545758