Indian Journal of Private Psychiatry

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VOLUME 18 , ISSUE 1 ( January-June, 2024 ) > List of Articles

Original Article

Effectiveness of Quetiapine as a Mood Stabilizer: A Case Series

Rachit Sharma, Ankit Dangi, Markanday Sharma, Mohit Agrawal

Keywords : Bipolar disorder, Effectiveness, India, Maintenance phase treatment, Monotherapy, Quetiapine

Citation Information : Sharma R, Dangi A, Sharma M, Agrawal M. Effectiveness of Quetiapine as a Mood Stabilizer: A Case Series. Ind J Priv Psychiatry 2024; 18 (1):13-18.

DOI: 10.5005/jp-journals-10067-0151

License: CC BY-NC 4.0

Published Online: 03-01-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Introduction: Bipolar affective disorder (BD) had a chronic episodic course with recurrent episodes of mania or depression, leading to socio-occupational dysfunction. Standard pharmacology is dependent on conventional mood stabilizers, such as lithium, divalproex sodium, and carbamazepine. The role of atypical antipsychotics is more as a first-line adjunct in manic episodes. Recently, the evidence in Europe and America is favoring for use of Quetiapine as a primary mood stabilizer for all phases and episodes of bipolar illness and has even been incorporated in clinical practice guidelines of some countries, including the recent Canadian Network for Mood and Anxiety Treatment 2018 guidelines (CANMAT). However, the prescribing pattern of Indian Psychiatrists weighs heavily on time-tested conventional mood stabilizers during acute episodes as well as during maintenance phases. Methodology: In order to understand and assess the effectiveness of quetiapine as a monotherapy in any phase of bipolar affective disorder without compromising the standard of care and as per clinical requirements, quetiapine was instituted/switched to 14 patients of BD in any phase of illness. Results: Two patients in manic episode, four patients in depressive episode, and one patient in mixed episode attained complete remission with quetiapine monotherapy. Medications of six patients were successfully switched from conventional mood stabilizers to quetiapine monotherapy without any signs of relapse. One patient already maintaining remission on a combination of quetiapine and valproate was continued on the same regimen due to patient preference. All patients, whether in the acute phase or maintenance phase, were noted to be in remission on maintenance dosages of 300 mg/day. Conclusion: Quetiapine monotherapy is effective in acute phases and long-term stabilization of BD and is a welcome drug for the Indian population also. But our findings differed from CANMAT 2018 guidelines in that, quetiapine as a mood stabilizer in monotherapy appears to be more promising in the maintenance phase of BD and only as an adjunct for acute phase management.


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