TORONTO – Quetiapine appears to improve symptoms of depression and suicidal ideation in adolescents with bipolar disorder, mood disorder, and those at familial risk of developing bipolar disorder, according to a poster presented at the joint annual meeting of the American Academy of Child and Adolescent Psychiatry and the Canadian Academy of Child and Adolescent Psychiatry.
Dr. Melissa DelBello of the University of Cincinnati and her colleagues presented the results of three studies of the drug in bipolar adolescents aged 12–18 years.
Study 1 included 30 adolescents hospitalized with mixed or manic episodes.
The patients were randomized to divalproex or divalproex plus quetiapine (mean dose 423 mg/day) for 6 weeks.
Those in the combination group experienced a greater mean decrease in depression scores from baseline than did those in the divalproex-only group (from 50 to 24 vs. 50 to 34, respectively).
Study 2 included 50 patients hospitalized with bipolar I disorder (94% mixed, 6% manic episodes).
They were randomized to quetiapine (Seroquel) monotherapy (mean dose 417 mg/day) or divalproex monotherapy for 4 weeks.
Mean depression scores in the quetiapine group decreased from 52 to 25. Dr. DelBello did not analyze the divalproex response in this study.
Study 3 included 25 hospitalized adolescents with a mood disorder and with at least one parent with bipolar disorder.
The adolescents received quetiapine monotherapy (mean dose 447 mg/day) for 12 weeks. Mean depression scores decreased from 40 to 29.
In the three studies, 65 patients who took quetiapine alone had major depression. Overall, their mean suicidality score decreased from 3.0 to 1.5.
The suicidality score increased, however, in two of the patients, both of whom were taking quetiapine.
Quetiapine was well tolerated alone and in combination with divalproex, Dr. DelBello said.
Sedation (mostly mild and transient) was the most common adverse event, followed by dizziness and gastrointestinal upset. No patients discontinued therapy because of adverse events.
The poster was sponsored by AstraZeneca.