Pini Stefano, Abelli Marianna, Cassano Giovanni B
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
Expert Opin Pharmacother. 2006 May;7(7):929-40. doi: 10.1517/14656566.7.7.929.
Through a review of randomised, controlled trials, this article evaluates the efficacy and tolerability of quetiapine in the acute and maintenance phases of bipolar disorder. In trials involving mania patients, quetiapine was found to be effective as adjunctive therapy in combination with lithium or valproate, significantly superior to placebo, and equal to lithium or haloperidol as monotherapy. With regard to the prevention of relapses in bipolar disorder, quetiapine seems to differ from other atypical antipsychotics in its characteristics as a mood stabiliser, which are associated with a promising efficacy in the treatment of bipolar depressive episodes. However, further larger controlled long-term prospective studies are needed to confirm the efficacy of quetiapine for the prevention of relapses in bipolar disorder. Quetiapine seems to have a satisfactory safety and tolerability profile, with a low prevalence of extrapyramidal symptom-related adverse events, treatment-emergent depression and weight gain. Sedation is the main side effect of treatment with quetiapine.
通过对随机对照试验的回顾，本文评估了喹硫平在双相情感障碍急性期和维持期的疗效及耐受性。在涉及躁狂症患者的试验中，发现喹硫平作为辅助治疗与锂盐或丙戊酸盐联合使用时有效，显著优于安慰剂，且作为单一疗法与锂盐或氟哌啶醇相当。关于双相情感障碍复发的预防，喹硫平作为一种心境稳定剂，其特性似乎与其他非典型抗精神病药物不同，这与在双相抑郁发作治疗中具有良好疗效相关。然而，需要进一步开展更大规模的对照长期前瞻性研究来证实喹硫平预防双相情感障碍复发的疗效。喹硫平似乎具有令人满意的安全性和耐受性，锥体外系症状相关不良事件、治疗中出现的抑郁及体重增加的发生率较低。镇静是喹硫平治疗的主要副作用。
