Intervention: Quetiapine Fumarate
Trial phase: Phase 4
SMILES: O=C(O)C=CC(=O)O.OCCOCCN1CCN(C2=Nc3ccccc3Sc3ccccc32)CC1.OCCOCCN1CCN(C2=Nc3ccccc3Sc3ccccc32)CC1
Sex: All
Age groups: Adult
Healthy volunteers: No
Participants at risk: 20
Group description: quetiapine (Seroquel XR) : Seroquel XR (starting dose 100mg and increased up to 400 mg as tolerated) treatment.
Eligibility criteria:
Inclusion Criteria:

Provision of written informed consent
A diagnosis of Major Depressive Episode by Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (DSM-IV)
Females or Males aged 18 - 60 years
Female subjects of childbearing potential must be using a reliable method of contraception and have a negative serum human chorionic gonadotropin (HCG) test at enrollment
Able to understand and comply with the requirements of the study
17-item Hamilton Depression Rating Scale (HDRS) score > 15
Hamilton Anxiety Scale (HAM-A) score > 15
Satisfy criteria to undergo an MRI scan based on MRI screening questionnaire

Able to be managed as outpatients for initial assessment and during treatment as ascertained by the following:

Symptoms not worsening by more than 10 points on the HDRS during the course of the study.
No danger to self or others.

Exclusion Criteria:

Pregnancy or lactation
Meeting DSM-IV criteria for schizophrenia, schizophreniform disorder, schizoaffective disorder, atypical psychosis, mental retardation, or organic mental (including organic mood) disorder
Subjects who, in the opinion of the investigator, pose an imminent risk of suicide or a danger to self or others
Known intolerance or lack of response to quetiapine fumarate, as judged by the investigator
Use of any of the following cytochrome P450 3A4 inhibitors in the 14 days preceding enrolment including but not limited to: ketoconazole, itraconazole, fluconazole, erythromycin, clarithromycin, troleandomycin, indinavir, nelfinavir, ritonavir, fluvoxamine and saquinavir
Use of any of the following cytochrome P450 inducers in the 14 days preceding enrolment including but not limited to: phenytoin, carbamazepine, barbiturates, rifampin, St. John's Wort, and glucocorticoids
Administration of a depot antipsychotic injection within one dosing interval (for the depot) before randomisation
Substance or alcohol dependence at enrollment (except dependence in full remission, and except for caffeine or nicotine dependence), as defined by DSM-IV criteria
Opiates, amphetamine, barbiturate, cocaine, cannabis, or hallucinogen abuse by DSM-IV criteria within four weeks prior to enrollment
Medical conditions that would affect absorption, distribution, metabolism, or excretion of study treatment
Unstable or inadequately treated medical illness (angina pectoris, hypertension) as judged by the investigator
Involvement in the planning and conduct of the study
Previous enrollment or randomization of treatment in the present study.
Participation in another drug trial within four weeks prior enrollment into this study or longer in accordance with local requirements
A subject with Diabetes Mellitus; people who develop hyperglycemia will be removed from the study
An absolute neutrophil count (ANC) of 1.5 x 109 per liter
Use of psychotropics in the past two weeks. If on fluoxetine in the past, then should not have been on this medication for four weeks.
History of lack of response to Quetiapine extended release.
Acutely suicidal or homicidal or requiring inpatient treatment.
Metallic implants.