TY - JOUR
T1 - Treatment of agitation and aggression in bipolar mania
T2 - Efficacy of quetiapine
AU - Buckley, Peter F.
AU - Paulsson, Björn
AU - Brecher, Martin
N1 - Funding Information:
These studies were supported by AstraZeneca Pharmaceuticals LP. The authors would like to acknowledge the assistance of Michelle O'Donovan, PhD and Aruna Seth, PhD (PAREXEL MMS), who provided medical writing support on behalf of AstraZeneca.
PY - 2007
Y1 - 2007
N2 - Objective: Agitation and aggression are potentially disruptive and dangerous features of bipolar mania. This analysis evaluated the effects of quetiapine on agitation and aggression in patients with bipolar I mania. Methods: Four double-blind, randomized, controlled trials were conducted using similar protocols; 407 patients with bipolar I mania were randomized to quetiapine monotherapy (200-800 mg/day) or placebo for 12 weeks, and 402 patients were randomized to quetiapine (200-800 mg/day) or placebo in combination with lithium (Li) or divalproex (DVP) for 3 or 6 weeks. Measurements of agitation included the Positive and Negative Syndrome Scale (PANSS) Activation subscale, PANSS Supplemental Aggression Risk subscale scores, and Young Mania Rating Scale (YMRS) items relevant to agitation. Results: Initial reductions in both the PANSS Activation and PANSS Supplemental Aggression Risk subscale scores were noted by Day 4 with quetiapine and placebo. The reduction in PANSS Activation subscale scores was significantly greater with quetiapine monotherapy than placebo first at Day 21 (- 3.5 versus - 1.4, P < 0.001) and also at Day 84 (- 4.8 versus - 1.2, P < 0.001). The improvement in PANSS Supplemental Aggression Risk subscale score was significantly greater with quetiapine monotherapy than placebo by Day 14 (P < 0.01) and all time points thereafter including Day 21 (- 4.0 versus - 1.8, P < 0.001) and Day 84 (- 5.6 versus - 1.7, P < 0.001). In combination therapy, the mean improvement in PANSS Activation subscale score at Day 21 was numerically but not significantly different with QTP +Li/DVP than PBO + Li/DVP (- 4.2 versus - 3.2, P = 0.087). The mean PANSS Supplemental Aggression Risk subscale scores were significantly improved at Day 21 with QTP + Li/DVP versus PBO + Li/DVP (- 5.05 versus - 3.69, P < 0.05). Conclusions: Quetiapine is an effective and appropriate treatment choice in managing agitation and aggression associated with bipolar mania.
AB - Objective: Agitation and aggression are potentially disruptive and dangerous features of bipolar mania. This analysis evaluated the effects of quetiapine on agitation and aggression in patients with bipolar I mania. Methods: Four double-blind, randomized, controlled trials were conducted using similar protocols; 407 patients with bipolar I mania were randomized to quetiapine monotherapy (200-800 mg/day) or placebo for 12 weeks, and 402 patients were randomized to quetiapine (200-800 mg/day) or placebo in combination with lithium (Li) or divalproex (DVP) for 3 or 6 weeks. Measurements of agitation included the Positive and Negative Syndrome Scale (PANSS) Activation subscale, PANSS Supplemental Aggression Risk subscale scores, and Young Mania Rating Scale (YMRS) items relevant to agitation. Results: Initial reductions in both the PANSS Activation and PANSS Supplemental Aggression Risk subscale scores were noted by Day 4 with quetiapine and placebo. The reduction in PANSS Activation subscale scores was significantly greater with quetiapine monotherapy than placebo first at Day 21 (- 3.5 versus - 1.4, P < 0.001) and also at Day 84 (- 4.8 versus - 1.2, P < 0.001). The improvement in PANSS Supplemental Aggression Risk subscale score was significantly greater with quetiapine monotherapy than placebo by Day 14 (P < 0.01) and all time points thereafter including Day 21 (- 4.0 versus - 1.8, P < 0.001) and Day 84 (- 5.6 versus - 1.7, P < 0.001). In combination therapy, the mean improvement in PANSS Activation subscale score at Day 21 was numerically but not significantly different with QTP +Li/DVP than PBO + Li/DVP (- 4.2 versus - 3.2, P = 0.087). The mean PANSS Supplemental Aggression Risk subscale scores were significantly improved at Day 21 with QTP + Li/DVP versus PBO + Li/DVP (- 5.05 versus - 3.69, P < 0.05). Conclusions: Quetiapine is an effective and appropriate treatment choice in managing agitation and aggression associated with bipolar mania.
KW - Aggression
KW - Agitation
KW - Bipolar disorder
KW - Quetiapine
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U2 - 10.1016/j.jad.2007.02.005
DO - 10.1016/j.jad.2007.02.005
M3 - Article
C2 - 17376537
AN - SCOPUS:34249291226
SN - 0165-0327
VL - 100
SP - S33-S43
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - SUPPL. 1
ER -