Comparison of the Effects of Quetiapine XR and Lithium Monotherapy on Actigraphy-Measured Circadian Parameters in Patients With Bipolar II Depression.
OBJECTIVE
The aim of this study was to evaluate the effects of quetiapine XR and lithium on actigraphy-measured circadian parameters in patients with bipolar II depression.


METHODS
This was an 8-week, open-label, prospective, randomized comparative study. The assessments included the 17-item Hamilton Depression Rating Scale score and actigraphic measures concerning the previous 7 days, collected at each visit (weeks 0 [baseline], 1, 2, 4, 6, and 8); the actigraphic data were analyzed with a cosinor analysis.


RESULTS
Medication, time, and the interaction between medication and time were significantly associated with acrophase for the entire group (Ps = 0.003, 0.020, and 0.042, respectively). More specifically, acrophase was significantly delayed at weeks 1 and 6 (Ps = 0.004 and 0.039, respectively) in the quetiapine XR group. The F statistics significantly increased over time for the entire group (P < 0.001), and there was a significant increase in F statistics on weeks 4 and 6 in the quetiapine XR group (Ps = 0.016 and 0.020, respectively) and on weeks 4 and 8 in the lithium group (Ps = 0.001 and 0.016, respectively). In addition, scores on the 17-item Hamilton Depression Rating Scale were significantly associated with the F statistics during 8 weeks for the entire group (P = 0.008).


CONCLUSIONS
Both quetiapine XR and lithium affected several circadian parameters, including peak activity time and robustness of circadian rhythm, but exerted different effects on acrophase in patients with bipolar II depression. In particular, clinical depressive symptoms were associated with robustness of circadian rhythm during the course of the 8-week treatment.
From the *Seoul National University College of Medicine; and †Department of Psychiatry, Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul; ‡Department of Psychiatry, Gil Medical Center, School of Medicine, Gachon University, Incheon; §Health Service Group, Samsung Electronics, Co, Ltd, Suwon; and ∥Department Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Jeong Yeon
JY
Hwang
Jae-Won
JW
Choi
Seung-Gul
SG
Kang
Su Hwan
SH
Hwang
Seog Ju
SJ
Kim
Yu Jin
YJ
Lee
D056044:Actigraphy; D000328:Adult; D018692:Antimanic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology; D002940:Circadian Rhythm / Q000187:drug effects*; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D000069348:Quetiapine Fumarate / Q000008:administration & dosage / Q000494:pharmacology*; D055815:Young Adult
D018692:Antimanic Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds; D000069348:Quetiapine Fumarate