Departamento de Bioquímica, ICBS - UFRGS, Porto Alegre, Brazil.
J Psychopharmacol. 2010 Mar;24(3):421-4. doi: 10.1177/0269881108097715. Epub 2008 Oct 6.
Patients with hyperthymic and cyclothymic temperaments often develop symptoms that fail to meet diagnostic criteria for bipolar disorders. These patients can be conceived as having bipolar disorder NOS (not otherwise specified), a bipolar spectrum disorder, cyclothymic disorder or cluster B personality traits. Here, we describe four of these patients with mild to moderate symptoms affecting mood, behaviour, emotional reactivity and sleep. Treatment with low-dose quetiapine (25-75 mg/day at night) lead to sustained symptom remission. Two of them were on quetiapine monotherapy. Such low doses occupy a minority of D2 and 5-HT2 receptors, which may nevertheless be of therapeutic value in mild cases. Alternatively, other mechanisms more likely to occur at low doses, such as antagonism of H1, alpha(1B)-adrenergic and other serotonin receptors, as well as reduction cortisol secretion, may be involved in the therapeutic efficacy of quetiapine.
心境高涨和环性心境的患者常出现不符合双相障碍诊断标准的症状。这些患者可被认为是双相障碍未特定型（NOS）、双相谱系障碍、环性心境障碍或 B 群人格特质。在此，我们描述了 4 例具有轻至中度影响情绪、行为、情绪反应和睡眠的症状的患者。低剂量喹硫平（每晚 25-75mg）治疗可使症状持续缓解。其中 2 例为喹硫平单药治疗。这些低剂量仅占据少数 D2 和 5-HT2 受体，然而，在轻度病例中可能具有治疗价值。或者，其他可能在低剂量更常出现的机制，如拮抗 H1、α1B-肾上腺素能和其他 5-羟色胺受体，以及减少皮质醇分泌，可能参与了喹硫平的治疗效果。
