Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T13:55:25.742Z Has data issue: false hasContentIssue false
  • English
  • Français

Is quetiapine effective for obsessive and compulsive symptoms in patients with bipolar disorder? A randomized, double-blind, placebo-controlled clinical trial

Published online by Cambridge University Press:  24 May 2021

Ali Sahraian ,
Bahareh Ghahremanpouri  and
Arash Mowla Open the ORCID record for Arash Mowla [Opens in a new window]
Ali Sahraian
Affiliation:
Research Center for Psychiatry and Behavioral Sciences, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Bahareh Ghahremanpouri
Affiliation:
Research Center for Psychiatry and Behavioral Sciences, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Arash Mowla*
Affiliation:
Substance Abuse and Mental Health Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
*
*Author for correspondence: Arash Mowla, MD Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The aim of this study is to examine the effects of quetiapine as an adjuvant treatment for obsessive–compulsive (OC) symptoms in patients with bipolar disorder (BD) type I.

Methods

In this 8-week double-blind placebo-controlled randomized clinical trial, 47 patients with BD in euthymic phase that had OC symptoms were randomly allocated to receive either quetiapine or placebo plus their routine medications (lithium + clonazepam). Yale–Brown Obsessive–Compulsive Scale (YBOCS) was used to assess the outcomes. Adverse effects were also recorded.

Results

Of 47 BD patients with OC symptoms that were randomly allocated in two groups of quetiapine (n = 24) and placebo group (n = 23), 40 patients (20 in quetiapine group and 20 in placebo group) completed the trial. Throughout the trial, the mean score of YBOCS in the quetiapine group dropped from 24.37 ± 1.51 to 15.26 ± 1.16 (P < .001) and in the placebo group decreased from 24.21 ± 1.33 to 23.94 ± 1.66 (P = 1.97). At the end of the study, 12 (60%) patients in the quetiapine group and 1 (5%) patient in the placebo group had more than 34% decline in YBOCS score (P < .001). No serious adverse effects were reported in two groups.

Conclusions

Our double-blind placebo-controlled clinical trial showed that quetiapine may be an effective adjuvant agent for reducing OC symptoms in BD patients.

Keywords

QuetiapineOCDbipolar disorderobsessioncompulsion
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 5 , October 2022 , pp. 634 - 638
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kessing, LV, Andersen, PK, Vinberg, M. Risk of recurrence after a single manic or mixed episode—a systematic review and meta-analysis. Bipolar Disord. 2018;20(1):9–17.CrossRefGoogle ScholarPubMed
Radua, J, Grunze, H, Amann, BL. Meta-analysis of the risk of subsequent mood episodes in bipolar disorder. Psychother Psychosom. 2017;86(2):90–98.CrossRefGoogle ScholarPubMed
Chen, YW, Dilsaver, SC. Comorbidity for obsessive–compulsive disorder in bipolar and unipolar disorders. Psychiatry Res. 1995;59(1–2):57–64.CrossRefGoogle ScholarPubMed
Merikangas, KR, Akiskal, HS, Angst, J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64(5):543–552.CrossRefGoogle ScholarPubMed
Amerio, A, Maina, G, Ghaemi, SN. Updates in treating comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review. J Affect Dis. 2019;256:433–440.CrossRefGoogle ScholarPubMed
Faravelli, C, Abrardi, L, Bartolozzi, D, et al. The Sesto Fiorentino study: background, methods and preliminary results. Lifetime prevalence of psychiatric disorders in an Italian community sample using clinical interviewers. Psychother Psychosom. 2004;73(4):216–225.CrossRefGoogle Scholar
Henry, C, Van den Bulke, D, Bellivier, F, et al. Anxiety disorders in 318 bipolar patients: prevalence and impact on illness severity and response to mood stabilizer. J Clin Psychiatry. 2003;64(3):331–335.CrossRefGoogle ScholarPubMed
Koyuncu, A, Tükel, R, Ozyildirim, I, et al. Impact of obsessive–compulsive disorder comorbidity on the sociodemographic and clinical features of patients with bipolar disorder. Compr Psychiatry. 2010;51(3):293–297.CrossRefGoogle ScholarPubMed
Shashidhara, M, Sushma, BR, Viswanath, B, et al. Comorbid obsessive compulsive disorder in patients with bipolar-I disorder. J Affect Disord. 2015;174:367–371.CrossRefGoogle ScholarPubMed
Magalhães, PV, Kapczinski, NS, Kapczinski, F. Correlates and impact of obsessive–compulsive comorbidity in bipolar disorder. Compr Psychiatry. 2010;51(4):353–356.CrossRefGoogle ScholarPubMed
Maj, M. “Psychiatric comorbidity”: an artefact of current diagnostic systems? Br J Psychiatry. 2005;186:182–184.CrossRefGoogle ScholarPubMed
Jeon, S, Baek, JH, Yang, SY, et al. Exploration of comorbid obsessive–compulsive disorder in patients with bipolar disorder: the clinic-based prevalence rate, symptoms nature and clinical correlates. J Affect Disord. 2018;225:227–233.CrossRefGoogle ScholarPubMed
Eddy, KT, Dutra, L, Bradley, R, Westen, D. A multi-dimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive–compulsive disorder. Clin Psychol Rev. 2004;24(8):1011–1030.CrossRefGoogle Scholar
Gao, K, Kemp, DE, Ganocy, SJ, et al. Treatment-emergent mania/hypomania during antidepressant monotherapy in patients with rapid cycling bipolar disorder. Bipolar Disord. 2008;10(8):907–915.CrossRefGoogle ScholarPubMed
Pittenger, C, Bloch, M. Pharmacological treatment of obsessive–compulsive disorder. Psychiatr Clin North Am. 2014;37(3):375–391.CrossRefGoogle ScholarPubMed
Barth, M, Kriston, L, Klostermann, S, et al. Efficacy of selective serotonin reuptake inhibitors and adverse events: meta-regression and mediation analysis of placebo-controlled trials. Br J Psychiatry. 2016;208(2):114–119.CrossRefGoogle ScholarPubMed
Srisurapanont, M, Maneeton, B, Maneeton, N, et al. Quetiapine for schizophrenia. Cochrane Database Syst Rev. 2004;2004(2):CD000967Google Scholar
Riedel, M, Muller, N, Strassnig, M, et al. Quetiapine in the treatment of schizophrenia and related disorders. Neuropsychiatr Dis Treat. 2007;3(2):219–235.CrossRefGoogle ScholarPubMed
Nemeroff, CB, Kinkead, B, Goldstein, J. Quetiapine: preclinical studies, pharmacokinetics, drug interactions, and dosing. J Clin Psychiatry. 2002;63(suppl 13):5–11.Google ScholarPubMed
Kordon, A, Wahl, K, Koch, N, et al. Quetiapine addition to serotonin reuptake inhibitors in patients with severe obsessive–compulsive disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol. 2008;28(5):550–554.CrossRefGoogle ScholarPubMed
Diniz, JB, Shavitt, RG, Fossaluza, V, et al. A double-blind, randomized, controlled trial of fluoxetine plus quetiapine or clomipramine versus fluoxetine plus placebo for obsessive–compulsive disorder. J Clin Psychopharmacol. 2011;31(6):763–768.CrossRefGoogle ScholarPubMed
Vulink, NC, Denys, D, Fluitman, SB, et al. Quetiapine augments the effect of citalopram in non-refractory obsessive–compulsive disorder: a randomized, double-blind, placebo-controlled study of 76 patients. J Clin Psychiatry. 2009;70(7):1001–1008.CrossRefGoogle ScholarPubMed
Kishi, T, Ikuta, T, Matsuda, Y, et al. Mood stabilizers and/or antipsychotics for bipolar disorder in the maintenance phase: a systematic review and network meta-analysis of randomized controlled trials. Mol Psychiatry. 2020. doi:10.1038/s41380-020-00946-6 Google ScholarPubMed
Poyurovsky, M, Braverman, L, Weizman, A. Beneficial effect of quetiapine monotherapy in patients with bipolar depression and comorbid obsessive–compulsive disorder. Int Clin Psychopharmacol. 2021;36(1):50–53.CrossRefGoogle ScholarPubMed
Escudero, MAG, Gutiérrez-Rojas, L, Lahera, G. Second-generation antipsychotics monotherapy as maintenance treatment for bipolar disorder: a systematic review of long-term studies. Psychiatr Q. 2020;91(4):1047–1060.CrossRefGoogle ScholarPubMed
Goodman, WK, Price, LH, Rasmussen, SA, et al. The Yale–Brown Obsessive–Compulsive Scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–1011.CrossRefGoogle ScholarPubMed
Sahraian, A, Ehsaei, Z, Mowla, A. Aripiprazole as an adjuvant treatment for obsessive and compulsive symptoms in manic phase of bipolar disorder: a randomized, double-blind, placebo-controlled clinical trial. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Pt A):267–271.CrossRefGoogle ScholarPubMed
Mowla, A, Ghaedsharaf, M. Pregabalin augmentation for resistant obsessive–compulsive disorder: a double-blind placebo-controlled clinical trial. CNS Spectr. 2020;25(4):552–556.CrossRefGoogle ScholarPubMed
Mowla, A, Khajeian, AM, Sahraian, A, et al. Topiramate augmentation in resistant OCD: a double-blind placebo-controlled clinical trial. CNS Spectr. 2010;15(11):613–617.CrossRefGoogle ScholarPubMed
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429–435.CrossRefGoogle ScholarPubMed
Hamilton, M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967;6:278–296.CrossRefGoogle ScholarPubMed
Amerio, A, Odone, A, Ghaemi, SN. Aripiprazole augmentation in treating comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review. J Affect Disord. 2019;249:15–19.CrossRefGoogle ScholarPubMed
Sahraian, A, Bigdeli, M, Ghanizadeh, A, et al. Topiramate as an adjuvant treatment for obsessive compulsive symptoms in patients with bipolar disorder: a randomized double-blind placebo-controlled clinical trial. J Affect Disord. 2014;166:201–205.CrossRefGoogle ScholarPubMed
Sahraian, A, Jahromi, LR, Ghanizadeh, A, et al. Memantine as an adjuvant treatment for obsessive–compulsive symptoms in manic phase of bipolar disorder: a randomized, double-blind, placebo-controlled clinical trial. J Clin Psychopharmacol. 2017;37(2):246–249.CrossRefGoogle ScholarPubMed