Suttajit S, et al. – This study suggest that quetiapine monotherapy is effective for acute bipolar depression and the prevention of mania/hypomania switching. Its common adverse effects are extrapyramidal side effects, sedation, somnolence, dizziness, fatigue, constipation, dry mouth, increased appetite, and weight gain. The lower risk of headache in quetiapine–treated patients with acute bipolar depression should be further investigated. The evidence for the use of quetiapine combined with mood stabilizers in children and adolescents with acute bipolar depression is too small to support the clinical practice. Methods
The authors included all randomized, controlled trials (RCTs) comparing quetiapine with other treatments, including placebo, in patients with acute bipolar depression (bipolar I or II disorder, major depressive episode).
Published and unpublished RCTs were identified using the Cochrane Central Register of Controlled Trials, MEDLINE, Web of Knowledge, CINAHL, PsycINFO, the EU Clinical Trials Register database, and ClinicalTrials.gov.
The primary outcome was the change scores of depression rating scales.
Eleven RCTs (n=3,488) were included.
Two of them were conducted in children and adolescents.
The change in depression scores was significantly greater in the quetiapine group compared with the placebo group (mean difference, [MD] =–4.66, 95% confidence interval [CI] –5.59 to –3.73).
The significant difference was observed from week 1.
Compared with placebo, quetiapine had higher incidence rates of extrapyramidal side effects, sedation, somnolence, dizziness, fatigue, constipation, dry mouth, increased appetite, and weight gain but lower risks of treatment–emergent mania and headache.
Quetiapine treatment was associated with significant improvement of clinical global impression, quality of life, sleep quality, anxiety, and functioning.
Istoric In Romania, in vremea comunismului, pshiatrii au fost incadrati in APR, ramura a celorlalte ramuri medicale.Dupa 1989 APR si-a coninuat prezenta, fiind in continuare condusa de urmasii lui Predescu, Gorgos, Angheluta & co. APR se face vinovat in fata istoriei printr-o selectie mafiotica care a coborit psihiatria romaneasca la un instrument de persecutie a regimului fata deorice aspiratie de innoire,de respingerea a numeroase valori care n-au incaput in breasla si au trebuit sa emigreze sau sa fie marginalizati, perspectiveneavind decit cei hiperadaptati la teroarea raului. Persecutiile fata de psihiatrii si chiar fata de unii bolnavi sunt cunoscute. Text integral