Quetiapine in the treatment of rapid cycling bipolar disorder


Dr Eduard Vieta Hospital Clínic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain. Tel.: +34 93 2275401; fax: +34 93 2275477; e-mail: evieta@clinic.ub.es


Vieta E, Parramon G, Padrell E, Nieto E, Martinez-Arán A, Corbella B, Colom F, Reinares M, Goikolea JM, Torrent C. Quetiapine in the treatment of rapid cycling bipolar disorder. Bipolar Disord 2002: 4: 335–340. © Blackwell Munksgaard, 2002

Introduction: 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.