Efficacy of Quetiapine Monotherapy and Combination Therapy for Patients with Bipolar Depression with Mixed Features: A Randomized Controlled Pilot Study
Effective pharmacotherapy of bipolar depression with mixed features defined by DSM-5 remains unclear in clinical treatment guidelines. Quetiapine (QTP) and valproate have potential treatment utility but are often inadequate as monotherapy. Meanwhile, the efficacy of combination therapies of QTP plus...
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MDPI AG
2023-02-01
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| Online Access: | https://www.mdpi.com/1424-8247/16/2/287 |
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| author | Zheng Wang Danhua Zhang Yanli Du Yin Wang Tingting Huang Chee H. Ng Huimin Huang Yanmeng Pan Jianbo Lai Shaohua Hu |
| author_facet | Zheng Wang Danhua Zhang Yanli Du Yin Wang Tingting Huang Chee H. Ng Huimin Huang Yanmeng Pan Jianbo Lai Shaohua Hu |
| author_sort | Zheng Wang |
| collection | DOAJ |
| description | Effective pharmacotherapy of bipolar depression with mixed features defined by DSM-5 remains unclear in clinical treatment guidelines. Quetiapine (QTP) and valproate have potential treatment utility but are often inadequate as monotherapy. Meanwhile, the efficacy of combination therapies of QTP plus valproate or lithium have yet to be verified. Hence, we conducted a randomized controlled pilot study to evaluate the efficacy of QTP monotherapy in patients with bipolar depression with mixed features defined by DSM-5 and compared the combination therapy of QTP plus valproate (QTP + V) versus QTP plus lithium (QTP + L) for those patients who responded insufficiently to QTP monotherapy. Data was analyzed according to the intent-to-treat population. Generalized linear mixed model was performed by using “nlme” package in R software. A total 56 patients were enrolled, among which, 35 patients responded to QTP alone, and 11 and 10 patients were randomly assigned to QTP + V and QTP + L group, respectively. Nearly 60% enrolled patients responded to QTP monotherapy at the first two weeks treatment. No statistically significant difference in efficacy between QTP + V and QTP + L was observed. In conclusion, QTP monotherapy appeared to be efficacious in patients with bipolar depression with mixed features, and for those who responded insufficiently to QTP, combining with either valproate or lithium appeared to have positive effects. |
| first_indexed | 2024-03-11T08:17:55Z |
| format | Article |
| id | doaj.art-6fc480fd03eb42f9a42e3303591e4a96 |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-11T08:17:55Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
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| series | Pharmaceuticals |
| spelling | doaj.art-6fc480fd03eb42f9a42e3303591e4a962023-11-16T22:37:34ZengMDPI AGPharmaceuticals1424-82472023-02-0116228710.3390/ph16020287Efficacy of Quetiapine Monotherapy and Combination Therapy for Patients with Bipolar Depression with Mixed Features: A Randomized Controlled Pilot StudyZheng Wang0Danhua Zhang1Yanli Du2Yin Wang3Tingting Huang4Chee H. Ng5Huimin Huang6Yanmeng Pan7Jianbo Lai8Shaohua Hu9Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Psychiatry, Dongyang People’s Hospital, Jinhua 322103, ChinaClinical Trial Unit, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 310005, ChinaAffiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Psychiatry, The Melbourne Clinic and St Vincent’s Hospital, University of Melbourne, Richmond, VIC 3121, AustraliaDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaEffective pharmacotherapy of bipolar depression with mixed features defined by DSM-5 remains unclear in clinical treatment guidelines. Quetiapine (QTP) and valproate have potential treatment utility but are often inadequate as monotherapy. Meanwhile, the efficacy of combination therapies of QTP plus valproate or lithium have yet to be verified. Hence, we conducted a randomized controlled pilot study to evaluate the efficacy of QTP monotherapy in patients with bipolar depression with mixed features defined by DSM-5 and compared the combination therapy of QTP plus valproate (QTP + V) versus QTP plus lithium (QTP + L) for those patients who responded insufficiently to QTP monotherapy. Data was analyzed according to the intent-to-treat population. Generalized linear mixed model was performed by using “nlme” package in R software. A total 56 patients were enrolled, among which, 35 patients responded to QTP alone, and 11 and 10 patients were randomly assigned to QTP + V and QTP + L group, respectively. Nearly 60% enrolled patients responded to QTP monotherapy at the first two weeks treatment. No statistically significant difference in efficacy between QTP + V and QTP + L was observed. In conclusion, QTP monotherapy appeared to be efficacious in patients with bipolar depression with mixed features, and for those who responded insufficiently to QTP, combining with either valproate or lithium appeared to have positive effects.https://www.mdpi.com/1424-8247/16/2/287bipolar depression with mixed featuresquetiapinevalproatelithiummonotherapycombination therapy |
| spellingShingle | Zheng Wang Danhua Zhang Yanli Du Yin Wang Tingting Huang Chee H. Ng Huimin Huang Yanmeng Pan Jianbo Lai Shaohua Hu Efficacy of Quetiapine Monotherapy and Combination Therapy for Patients with Bipolar Depression with Mixed Features: A Randomized Controlled Pilot Study Pharmaceuticals bipolar depression with mixed features quetiapine valproate lithium monotherapy combination therapy |
| title | Efficacy of Quetiapine Monotherapy and Combination Therapy for Patients with Bipolar Depression with Mixed Features: A Randomized Controlled Pilot Study |
| title_full | Efficacy of Quetiapine Monotherapy and Combination Therapy for Patients with Bipolar Depression with Mixed Features: A Randomized Controlled Pilot Study |
| title_fullStr | Efficacy of Quetiapine Monotherapy and Combination Therapy for Patients with Bipolar Depression with Mixed Features: A Randomized Controlled Pilot Study |
| title_full_unstemmed | Efficacy of Quetiapine Monotherapy and Combination Therapy for Patients with Bipolar Depression with Mixed Features: A Randomized Controlled Pilot Study |
| title_short | Efficacy of Quetiapine Monotherapy and Combination Therapy for Patients with Bipolar Depression with Mixed Features: A Randomized Controlled Pilot Study |
| title_sort | efficacy of quetiapine monotherapy and combination therapy for patients with bipolar depression with mixed features a randomized controlled pilot study |
| topic | bipolar depression with mixed features quetiapine valproate lithium monotherapy combination therapy |
| url | https://www.mdpi.com/1424-8247/16/2/287 |
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