Quetiapine in the treatment of rapid cycling bipolar disorder.
BACKGROUND
This prospective open-label study assessed the impact of add-on quetiapine in the treatment of rapid cycling bipolar patients.


METHODS
Fourteen rapid cycling bipolar patients were treated with quetiapine, which was added to their ongoing medication regimen for 112 +/- 33 days. At the beginning of the study, five were manic, three were in a mixed state, three were depressed, two hypomanic and one was euthymic. Patients were assessed prospectively with a modified version of the Clinical Global Impression Scale for Bipolars (CGI-BP), the Young Scale for mania (YMRS) and the Hamilton Scale for Depression (HDRS).


RESULTS
A significant reduction of the following scale scores was observed: a 1.8 point reduction for the general CGI-BP (p = 0.013), a -1.3 point for the mania subscale (p = 0.016), a -1.01 point for the YMRS (p = 0.025). Improvement in depressive symptoms was not significant, neither in the CGI-BP (-1 point, p = 0.074) nor in the HDRS (-5.2 points, p = NS). The most common side-effect was sedation (n = 6, 43%). Doses of quetiapine were significantly reduced by the end of the study (443 +/- 235 mg/day versus 268 +/- 190 mg/day, p = 0.008) and they also differed according to the initial episode to be treated (720 +/- 84 mg/day for mania, and 183 +/- 29 mg/day for depression, p = 0.023).


CONCLUSIONS
Quetiapine could possibly be an effective treatment for rapid cycling bipolar patients. Adequate doses for acute episodes could significantly differ according to the episode polarity and the length of treatment.
Vieta
Eduard
E
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, Barcelona. Spain. evieta@clinic.ub.es
Parramon
Gemma
G
Padrell
Elena
E
Nieto
Evaristo
E
Martinez-Arán
Anabel
A
Corbella
Barbara
B
Colom
Francesc
F
Reinares
Maria
M
Goikolea
Jose M
JM
Torrent
Carla
C
D000204:Activity Cycles / Q000502:physiology*; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy*; D003987:Dibenzothiazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069348:Quetiapine Fumarate; D011795:Surveys and Questionnaires
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate