"To our knowledge there have been no other studies investigating atypical antipsychotics for the treatment of mood disorders in at-risk adolescents," said principal investigator Melissa P DelBello, MD, assistant professor of psychiatry and pediatrics, University of Cincinnati College of Medicine, and co-director, Mood Disorders Program, Children's Hospital Medical Center, Cincinnati, Ohio.

Children who have at least one parent with bipolar disorder have an increased risk of developing the disorder, Dr. DelBello noted in her presentation on October 27^th. In addition, several prodromal symptoms -- such as cyclothymia, depression, and subsyndromal mania -- can be precursors of bipolar disorder.

To determine whether treatment with a flexible dose of quetiapine would be tolerated in such patients, Dr. DelBello and colleagues conducted a single-blind study that involved 20 adolescents with a mood disorder other than bipolar I and at least one parent with bipolar disorder. The study included patients who had a Young Mania Rating Scale (YMRS) score of at least 12 or a Children's Depression Rating Scale-Revised (CDRS-R) score at least 28.

The investigators primarily tracked changes in YMRS and CDRS-R scores after 84 days.

Study participants were an average of 14.7 years old and ranged in age from 12 to 18 years. Among these subjects, 11 had bipolar disorder not otherwise specified; three had dysthymia; three had bipolar II disorder; two had cyclothymia, and one had major depressive disorder.

Mean baseline scores on the YMRS and CDRS-R were 18.1 and 38.2, respectively. By the study's end, the YMRS scores averaged 8.7 and the CDRS-R scores averaged 27.7, both of which were significantly improved over baseline (P < .001 for each).

Among the original 20 patients, 5 dropped out of the study -- 1 due to lack of response; 1 due to exacerbation of symptoms; 3 due to withdrawn consent. Adverse events, experienced by most patients, were typically mild, with the most frequent consisting of somnolence (55%) and headache (25%). No patients withdrew due to adverse events, and no patients had episodes of suicidality or mania.

Therefore, the investigators concluded that quetiapine may be an effective treatment for adolescents at risk of mood disorders, and Dr. DelBello recommended larger-scale double-blind studies to validate these findings.

Seroquel is manufactured by AstraZeneca, which funded the study.


[Presentation title: Quetiapine Efficacy in Adolescents With Mood Disorders and a Family of Bipolar Disorder. Abstract D19]

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