engleski

Effectiveness of quetiapine treatment in patients with manic episode who didn't respond well to previous treatment

Bipolar disorder is a serious public health problem with significant morbidity and mortality, and typically recurrent with lifelong vulnerability. Previous investigations showed that quetiapine has efficacy against manic symptoms in patients with bipolar I disorder. Objective was to assess the effectiveness of quetiapine treatment in the open-label, non- comparative, 12-week study with flexible doses of quetiapine in patients with manic episode who had inadequate response to or intolerance of their previous therapy. Thirty patients with manic episode according to DSM-IV TR diagnostic criteria were switched to quetiapine during hospitalization in Vrapce Psychiatric Hospital in the period from April to July 2006. Patients were switched due to inadequate response to or intolerance of their previous therapy. The Clinical Global Impression (CGI) and Young Mania Rating Scale (YMRS) were used in order to assess effectiveness of treatment with quetiapine. Quetiapine was introduced at dose of 50 mg on day one, followed by 100 mg, 200 mg and 300 mg on days 2, 3, and 4. After day 4, the daily dosage was between 300 mg and 900 mg. The patients were assessed prior to initiation of quetiapine treatment, on weekly basis during first four weeks and later every four weeks of continuous therapy with quetiapine. Statistical significance was set to p<0.05. After twelve weeks of continuous therapy with quetiapine, YMRS total score significantly decreased in the group of patients who were switched to quetiapine because of inadequate response to previous therapy, but not in the group of patients with intolerance of their previous therapy. The mean CGI severity score for all patients improved from 3.9 ("moderately ill") to 2.4 ("mildly III"). Administration of quetiapine was clinically beneficial for the patients with manic episode who had inadequate response to or intolerance of their previous antipsychotic therapy. References: 1. Jarema M. Atypical antipsychotics in the treatment of mood disorders. Curr Opin Psychiatry 2007 ; 20(1):23-29. 2. GUY W 1976 Clinical global impressions. In: ECDEU Assessment Manual for Psychopharmacology Revised, US Department of Health, Education and Welfare, Rockville, Maryland, p 217. 3. Young RC, Biggs 17, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978 ; 133:429-435. 4. Kozumplik O, Folnegovic-Smalc V, Jukic V, Mimica N, Uzun S. Quality of life in patients with paranoid schizophrenia treated with typical and atypical antipsychotics. Sch Research 2004 ; 67(1 ):228.

quetiapine; treatment; manic patients

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