Psychiatry & Mental Health Viewpoints, February 2009
Duffy A, Milin R, Grof P
BMC Psychiatry. 2009;9:4
This 48-week, open, prospective study evaluated the efficacy and tolerability of quetiapine as maintenance therapy to prevent relapse or recurrence of acute mood episodes in adolescents meeting DSM-IV lifetime criteria for a bipolar disorder. After stabilization of the acute episode (CGI-S ≤ 3 for 4 consecutive weeks), 21 patients were started or continued on quetiapine and weaned off other medications over an 8-week period. Quetiapine monotherapy was continued for 40 weeks, with addition of other mood stabilizers or antidepressants if needed. A neurocognitive test battery assessing the most reliable findings in adult patients was administered at fixed time points throughout the study to patients and matched controls.
Of 18 patients who completed the 48-week study, 13 had good quality remission on quetiapine monotherapy without relapse or recurrence, but 5 needed additional medication for residual symptoms of depression and/or anxiety. Quality of remission was very good for all patients, based on symptom ratings and global functioning scores. During treatment, neurocognitive test performance was not different from that of a matched control group of never mentally ill adolescents. Overall, no serious adverse effects were reported, and quetiapine was well tolerated, although routine laboratory testing showed some neutropenia that was not clinically significant.
Although this was a small, nonrandomized, nonblinded, open-label study, the findings suggest that quetiapine monotherapy effectively and safely maintains remission in a significant proportion of adolescents with bipolar disorder. Early diagnosis and effective stabilization may help ensure good quality of clinical remission and preservation of neurocognitive functioning. However, close monitoring and high adherence may have contributed to the good quality of clinical remission. The clinical profile of patients in this study (a non-fully remitting bipolar disorder associated with psychotic features) differed from that in patients known to respond well and to tolerate maintenance treatment with lithium.
Abstract
Duffy A, Milin R, Grof P
BMC Psychiatry. 2009;9:4
This 48-week, open, prospective study evaluated the efficacy and tolerability of quetiapine as maintenance therapy to prevent relapse or recurrence of acute mood episodes in adolescents meeting DSM-IV lifetime criteria for a bipolar disorder. After stabilization of the acute episode (CGI-S ≤ 3 for 4 consecutive weeks), 21 patients were started or continued on quetiapine and weaned off other medications over an 8-week period. Quetiapine monotherapy was continued for 40 weeks, with addition of other mood stabilizers or antidepressants if needed. A neurocognitive test battery assessing the most reliable findings in adult patients was administered at fixed time points throughout the study to patients and matched controls.
Of 18 patients who completed the 48-week study, 13 had good quality remission on quetiapine monotherapy without relapse or recurrence, but 5 needed additional medication for residual symptoms of depression and/or anxiety. Quality of remission was very good for all patients, based on symptom ratings and global functioning scores. During treatment, neurocognitive test performance was not different from that of a matched control group of never mentally ill adolescents. Overall, no serious adverse effects were reported, and quetiapine was well tolerated, although routine laboratory testing showed some neutropenia that was not clinically significant.
Although this was a small, nonrandomized, nonblinded, open-label study, the findings suggest that quetiapine monotherapy effectively and safely maintains remission in a significant proportion of adolescents with bipolar disorder. Early diagnosis and effective stabilization may help ensure good quality of clinical remission and preservation of neurocognitive functioning. However, close monitoring and high adherence may have contributed to the good quality of clinical remission. The clinical profile of patients in this study (a non-fully remitting bipolar disorder associated with psychotic features) differed from that in patients known to respond well and to tolerate maintenance treatment with lithium.
Abstract