Lancet Psychiatry

Quetiapine bests lithium in tough depression cases

March 28, 2025

Quetiapine may be a more effective and cost-efficient augmentation strategy than lithium as a first-line option for long-term management of treatment-resistant depression.

Study details: This pragmatic, open-label, randomized controlled trial included 212 adults with treatment-resistant major depressive disorder, unresponsive to ≥2 antidepressant trials, who were randomized to receive lithium or quetiapine augmentation.

Results: Participants in the quetiapine group exhibited significantly lower depressive symptom severity, measured by weekly self-rated Quick Inventory of Depressive Symptomatology (QID-SR) scores, over 12 months compared with the lithium group (area under the curve difference: -68.36, 95% confidence interval [CI] -129.95 to -6.76; p=0.0296). Time to all-cause treatment discontinuation didn’t differ significantly between groups and quetiapine was found to be more cost-effective. Serious adverse events were similar between groups, with overdose being the most common.

Source:

Cleare AJ, et al; LQD Study Group. (2025, April). Lancet Psychiatry. Clinical and cost-effectiveness of lithium versus quetiapine augmentation for treatment-resistant depression: a pragmatic, open-label, parallel-group, randomised controlled superiority trial in the UK. https://pubmed.ncbi.nlm.nih.gov/40113355/