Lei Li-Lei, Ge Chen-Jie, Wang Hong, Fang Yu, Zeng Lei, Wang Shi-Liang, Qian Min-Cai
Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China.
Quality Management Division, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China.
World J Psychiatry. 2025 Aug 19;15(8):104221. doi: 10.5498/wjp.v15.i8.104221.
Bipolar disorder (BD), marked by recurring manic and depressive episodes, often coexists with anxiety disorder (AD), which increases treatment complexity and morbidity. Although quetiapine, an atypical antipsychotic, has demonstrated efficacy in treating BD and AD, further investigation is needed regarding its effectiveness and safety in patients with AD at high-risk factors for BD.
To explore the application and efficacy of quetiapine in combination therapy for patients with AD at high-risk factors for BD.
This study included 67 patients, with two excluded, leaving 65 divided into Group A (sertraline treatment) and Group B (combination treatment). All patients received sertraline, with Group B additionally receiving quetiapine. Efficacy was assessed using the Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and Bech-Rafaelsen Mania sale (BRMS) throughout the treatment period. Side effects and physiological indicators were also monitored.
No significant baseline differences existed between the two groups at treatment onset. Over the treatment course, Group B exhibited significantly lower HAMA scores than Group A at the end of weeks 1 and 24. HAMD scores gradually decreased over time, with Group B consistently showing lower scores than Group A. BRMS scores decreased significantly from baseline by week 8. In Group A, 27.27% of patients received zolpidem treatment compared to 10.53% in Group B, which was a significant difference. Incidence of adverse reactions did not differ significantly between groups at treatment onset, but most patients experienced relief from adverse reactions within 4 weeks.
Combination of quetiapine and sertraline can more rapidly alleviate anxiety and depressive symptoms in patients with AD at high-risk factors for BD, improving treatment outcomes.
双相情感障碍（BD）以反复出现的躁狂和抑郁发作为特征，常与焦虑症（AD）共存，这增加了治疗的复杂性和发病率。尽管非典型抗精神病药物喹硫平已被证明对治疗BD和AD有效，但对于有BD高危因素的AD患者，其有效性和安全性仍需进一步研究。
探讨喹硫平在有BD高危因素的AD患者联合治疗中的应用及疗效。
本研究纳入67例患者，排除2例，将65例患者分为A组（舍曲林治疗）和B组（联合治疗）。所有患者均接受舍曲林治疗，B组额外接受喹硫平治疗。在整个治疗期间，使用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）和Bech-Rafaelsen躁狂量表（BRMS）评估疗效。同时监测副作用和生理指标。
两组治疗开始时的基线无显著差异。在治疗过程中，B组在第1周和第24周结束时的HAMA评分显著低于A组。HAMD评分随时间逐渐降低，B组始终低于A组。BRMS评分在第8周时较基线显著下降。A组有27.27%的患者接受了唑吡坦治疗，而B组为10.53%，差异有统计学意义。两组治疗开始时不良反应发生率无显著差异，但大多数患者在4周内不良反应得到缓解。
喹硫平与舍曲林联合应用可更快缓解有BD高危因素的AD患者的焦虑和抑郁症状，改善治疗效果。
