양극성 우울증에서 Quetiapine의 효능：다기관, 전향적, 개방형, 관찰 연구(QUEEN Study)

Efficacy of Quetiapine in Patients with Bipolar Depression：A Multi-Center, Prospective, Open-label, Observational Study(The QUEEN Study)

Objective：Bipolar depression has a disabling course and its treatment represents a major challenge. Recently, arandomized, controlled trial of quetiapine monotherapy in patients with bipolar depression showed significant reductionsin depressive symptomatology. The purpose of this study was to evaluate the efficacy of quetiapine in bipolar depression in the clinical setting. Methods：This study was a multi-center, prospective, open-label, observational 8-week evaluation of the efficacy of quetiapine in patients with bipolar depression. Patients with a DSM-IV-TR diagnosis of bipolar depression (bipolar I disorder, most recent episode depressed and bipolar II disorder, most recent episode depressed) were included and treated with quetiapine. The dose of quetiapine was flexible and concomitant mediations were permitted, by clinical judgment. Clinical improvements were rated with the Clinical Global Impression-Bipolar version (CGI-BP) and Montgomery-Asberg Depression Rating Scale (MADRS) at baseline, week 4, and week 8. Results：A total of 1,193 patients were recruited and 46 (3.9%) patients were dropped from the study. The mean initial dose of quetiapine was 192.3±181.9 mg/day and the mean doses at weeks 4 and 8 were 315.2±229.7 mg/day and 337.1±229.9 mg/day, respectively. CGI-BP and MADRS were significantly improved at weeks 4 and 8, compared with baseline. In addition, improvements at week 8 were greater than at week 4. Subjectively, about 75% of the patients reported therapeutic compliance above 75% at weeks 4 and 8. Seven (0.6%) and four (0.3%) patients showed manic/hypomanic episodes at weeks 4 and 8, respectively. Conclusion：This study suggests that quetiapine improves depressive symptoms in bipolar depression, with mi- nimal incidence of manic switching. We suggest that quetiapine could be an effective and safe option in treating bipolar depression.