Date - 28 February 2005

Source- Drugs in Context 2005; 1(2): Quetiapine - Bipolar Disorder p57

Author - Dr Richard Clark

Quetiapine is an atypical antipsychotic that is used in the management of bipolar disorder, primarily for episodes of mania, either as monotherapy or as an adjunctive therapy to mood stabilisers. It is also licensed for the treatment of schizophrenia. Quetiapine appears to be effective in treating depressive episodes of bipolar disorder and is effective as a long-term maintenance therapy for the condition, though it is currently unlicensed for these indications. More specifically, quetiapine has been shown to have a comparable effect to lithium and haloperidol in the management of manic episodes and is at least as effective as olanzapine in this regard. Moreover, quetiapine has a more favourable overall tolerability profile than these other agents. When quetiapine was added to the mood stabilisers, lithium and valproate, a significant increase in the number of patients achieving response and remission was reported. Quetiapine monotherapy was also shown to have a large treatment effect when managing patients with bipolar depression. Consistent with the experience from clinical trials of quetiapine in the management of schizophrenia, quetiapine has a placebo-like effect on extrapyramidal symptoms (EPS) and prolactin levels. Quetiapine is associated with a favourable long-term weight profile so that in patients in whom weight gain is an important consideration, the use of quetiapine may be advisable.

Keywords: Bipolar disorder, quetiapine, antipsychotics, mania, depressive phase