International guidelines consider quetiapine at medium doses (300-400 mg/day) as valid options for the treatment of bipolar depression for the supposed lower risk of a switch to hypomania/mania than antidepressants. Norquetiapine is an active metabolite with antidepressant action. We describe three cases of induced hypomania in bipolar type 2 subjects who received quetiapine extended-release monotherapy (300 mg/day) for a mild/moderate major depressive episode. Quetiapine and norquetiapine plasma concentrations were measured after 1 week of treatment. Hypomania appeared after 7-10 days of quetiapine extended-release monotherapy and all subjects had a quetiapine/norquetiapine plasma concentration ratio <1. We propose a ratio value <1 as a predictor of risk for a switch to hypomania in bipolar depressed subjects receiving quetiapine extended-release monotherapy. Future research should ascertain the validity of this laboratory parameter to assess the risk of quetiapine-induced hypomania in large samples of bipolar patients

Quetiapine-Induced Hypomania and its Association with Quetiapine/Norquetiapine Plasma Concentrations : A Case Series of Bipolar Type 2 Patients / C. Rovera, C. Esposito, V. Ciappolino, D. Cattaneo, S. Baldelli, E.G.I. Clementi, A.C. Altamura, M. Buoli. - In: DRUG SAFETY - CASE REPORTS. - ISSN 2198-977X. - 4:(2017 Dec). [10.1007/s40800-017-0057-9]

Quetiapine-Induced Hypomania and its Association with Quetiapine/Norquetiapine Plasma Concentrations : A Case Series of Bipolar Type 2 Patients

C. Esposito;S. Baldelli;E.G.I. Clementi;A.C. Altamura
Penultimo
;
M. Buoli
Ultimo
2017

Abstract

International guidelines consider quetiapine at medium doses (300-400 mg/day) as valid options for the treatment of bipolar depression for the supposed lower risk of a switch to hypomania/mania than antidepressants. Norquetiapine is an active metabolite with antidepressant action. We describe three cases of induced hypomania in bipolar type 2 subjects who received quetiapine extended-release monotherapy (300 mg/day) for a mild/moderate major depressive episode. Quetiapine and norquetiapine plasma concentrations were measured after 1 week of treatment. Hypomania appeared after 7-10 days of quetiapine extended-release monotherapy and all subjects had a quetiapine/norquetiapine plasma concentration ratio <1. We propose a ratio value <1 as a predictor of risk for a switch to hypomania in bipolar depressed subjects receiving quetiapine extended-release monotherapy. Future research should ascertain the validity of this laboratory parameter to assess the risk of quetiapine-induced hypomania in large samples of bipolar patients
bipolar depression; hypomania; quetiapine
Settore MED/25 - Psichiatria
Settore BIO/14 - Farmacologia
dic-2017
23-ott-2017
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/528136
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