Abstract
Objective:
The aim of this study was to evaluate the tolerability and efficacy of rapid quetiapine loading in youth diagnosed with pediatric bipolar disorder (PBD).
Method:
Quetiapine was started at 100 mg/day, and increased to 400 mg/day by day 5 in 75 bipolar children (6–16 years), presenting in an acute manic or hypomanic episode. Subsequent dose adjustments were predicated on the clinical picture. Response was defined as a ≥50% reduction in baseline scores on the Young Mania Rating Scale (YMRS). Clinical Global Impression–Improvement Scale (CGI-I) scores of “2 much improved” or “1 very much improved” were used as secondary measures of response. Remission was defined as a YMRS score of ≤12. Adverse events, blood pressure, weight change, somnolence, extrapyramidal syndrome (EPS), and akathisia were monitored to determine tolerability.
Results:
At 8 weeks, 94% of the sample had a CGI-I score ≤2, and 70% were in remission at 6 months. Sedation was reported by 50% of subjects during the first week; this rate dropped to 5.6% at 6 months.
Conclusion:
The findings indicate that rapid dose administration of quetiapine in children and adolescents with PBD is generally well tolerated and efficacious.
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