Beneficial effect of quetiapine monotherapy in patients with bipolar depression and comorbid obsessive-compulsive disorder

Abstract

Obsessive-compulsive disorder (OCD) is a prevalent and clinically significant comorbid condition in patients with bipolar disorder. Treatment of bipolar disorder/OCD patients is challenging. We report the results of an open-label, short-term, prospective investigation of quetiapine monotherapy in 16 patients (three men and 13 women, aged 18–56 years) hospitalized for acute bipolar depression who in addition met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for OCD. The participants were treated with quetiapine in a dose range of 150–600 mg (mean 347 mg) for a mean duration of 4.3 ± 1.4 weeks (range 3–7 weeks). Eleven (68.8%) of the 16 study participants fulfilled the predefined criteria for response, namely a score of ‘very much improved’ (four patients) and ‘much improved’ (seven patients) on the Clinical Global Impression – Improvement scale. Treatment with quetiapine was associated with a statistically significant decrease from baseline in the relevant rating scales for the assessment of depressive, manic and OCD symptoms. Quetiapine was well tolerated. The most frequently reported side effects were sedation, orthostatic hypotension and constipation. Durability of the positive therapeutic effect of quetiapine monotherapy in patients with bipolar disorder/OCD comorbidity and the necessity for subsequent augmentation with anti-OCD agents need to be addressed in future controlled studies.

Beneficial Effect of Quetiapine on Sleep, Anxiety, Depression and Myalgia Symptoms in a Patient With Post–COVID-19 Condition

“…Notably, inflammatory markers evaluated in our patient were within normal range. The revealed robust and rapid response to quetiapine was akin to that we found in patients with comorbid bipolar and obsessive-compulsive disorders 6,7 . However, although there is overlap, there are major differences between the cyclothymic and obsessive-compulsive personality traits revealed in our patient and clinical presentations of bipolar and obsessive-compulsive disorders.…”

Obsessive-compulsive symptoms in major depressive disorder correlate with clinical severity and mixed features

“…In fact, OCS showed a clearcut association with the lack of antidepressant response, which was confirmed after controlling for potentially confounding variables such as baseline depression severity and bipolar clinical risk score. This finding may suggest the use of specific treatments for these patients (De Berardis et al, 2020;Fineberg et al, 2020;Yousefzadeh et al, 2020;Poyurovsky, et al, 2021). Conversely, OCS had no impact on the risk of hypomanic switch during antidepressant use.…”

Synthesis, evaluation of drug delivery potential, and the quantum chemical investigation on a molecular imprinted polymer for quetiapine antipsychotic; a joint experimental and density functional theory study

“…Quetiapine (which has a six-membered heterocyclic ring as a biologically active part of this molecule) is one of the most important atypical antipsychotic drugs which have been used to treat some mental illnesses such as schizophrenia, bipolar disorder, and depression (Poyurovsky et al, 2020). This compound operates to restore the balance of some special chemical neurotransmitters or messengers in the central nervous system (CNS), which improves mood, behavior, and thinking (Garakani et al, 2020).…”