Quetiapine alone and added to a mood
stabilizer for serious mood disorders
by
Sajatovic M, Brescan DW, Perez DE,
DiGiovanni SK, Hattab H, Ray JB, Bingham CR.
Department of Psychiatry,
Case Western Reserve University,
Cleveland, Ohio, USA.
J Clin Psychiatry 2001 Sep; 62(9):728-32
ABSTRACT
BACKGROUND: Use of antipsychotic medication intermittently
or over the long term may be necessary in treating patients with bipolar
disorder whose symptoms have responded suboptimally to standard mood-stabilizing
agents. Quetiapine fumarate is an effective novel antipsychotic with mixed
serotonergic (5-HT2) and dopaminergic (D2) activity. This is an open-label,
12-week prospective study to assess the efficacy and tolerability of quetiapine
in the treatment of patients with bipolar and schizoaffective disorder who
were suboptimally responsive to mood stabilizers alone. METHOD: Participants
in the study were inpatients or outpatients with a DSM-IV diagnosis of bipolar
or schizoaffective disorder. Baseline psychopathology was evaluated with
the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale
(YMRS), and the Hamilton Rating Scale for Depression (HAM-D). Involuntary
movements were rated with the Simpson-Angus Neurologic Rating Scale. Quetiapine
was added on an open-label basis and increased to optimum clinical dosage.
Psychopathology and Abnormal Involuntary Movement Scale ratings were repeated
weekly for the first 4 weeks and then again at weeks 8 and 12. RESULTS:
Ten individuals with bipolar disorder and 10 with schizoaffective disorder
received quetiapine therapy. Overall, patients improved, with significant
improvement in BPRS (p < .001), YMRS (p = .043), and HAM-D scores (p = .002).
Simpson-Angus score also significantly decreased (p = .02). Overall. quetiapine
was well tolerated by patients in this group with serious mood disorders.
The mean +/- SD quetiapine dose was 202.9 +/- 124.3 mg/day (range, 50-400
mg/day). Mean weight gain was 10.9 lb (4.9 kg). CONCLUSION: Although limited
by its small size, open-label design, and relative gender homogeneity, this
study suggests that quetiapine therapy may be useful in the treatment of
individuals with serious mood disorders who are suboptimally responsive
to mood stabilizers alone. These preliminary findings should be explored
in larger, controlled trials.
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