Quetiapine combined with escitalopram in the treatment of bipolar depression along with effects on inflammation and oxidative stress.

Pingping Zhang, Jinchang Huang, Zheng Xiong, Xueqin Liu, Haiying Peng
Author Information
  1. Pingping Zhang: Department of Child and Adolescent Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, China.
  2. Jinchang Huang: Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, China.
  3. Zheng Xiong: Department of Bipolar Disorde, Shenzhen Kangning Hospital, Shenzhen, China.
  4. Xueqin Liu: Department of Child and Adolescent Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, China.
  5. Haiying Peng: Department of Pathology, Ganzhou Fifth People's Hospital, Ganzhou, China. ORCID

Abstract

OBJECTIVES: To assess the efficacy of escitalopram combined with quetiapine vs quetiapine alone in the treatment of depressive episodes of bipolar disorder (BPD).
METHODS: 88 hospitalized patients with a BPD depressive episode were recruited into the study. All patients were randomized to a control group (n = 44) or the intervention group (n = 44). Members of the control group received quetiapine fumarate alone, with an initial dose 50 mg/time twice/day; the dose was increased by 50-100 mg daily until 300-600 mg/d was reached. The treatment group received quetiapine at the same doses plus escitalopram, with the initial dose of escitalopram 10 mg/d, adjusting the dose to 20 mg/d after 1 week. Both groups were treated for 8 weeks. The scores on the Hamilton Depression Scale (HAMD) and Young Mania Rating Scale (YMRS), along with levels of IL-6, IL-1��, MIF, SOD, CAT, MDA and GSH-Px, were compared between groups.
RESULTS: Among those in the intervention group, 88.6% of participants experienced a 50% or greater reduction in HAMD score compared to 70.5% in the control group ( < .05). Participants in the intervention group also experienced a significantly greater reduction in IL-6, IL-1��, MIF and MDA levels ( < .05), and a significant increase in SOD, CAT and GSH-Px levels compared to the control group ( < .05).
CONCLUSION: Escitalopram oxalate combined with quetiapine is more effective than quetiapine alone in the treatment of patients with bipolar depressive episodes, which can effectively improve the symptoms of depression, inhibit the body's inflammatory response, regulate the state of oxidative stress, and does not increase the risk of mania.

Keywords

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Created with Highcharts 10.0.0groupquetiapineescitalopramtreatmentdepressivebipolarcontroldosecombinedaloneepisodespatientsinterventionHAMDlevelscompared<05disorderBPD88n=44receivedinitialgroupsScaleYMRSalongIL-6IL-1��MIFSODCATMDAGSH-PxexperiencedgreaterreductionincreaseoxalatedepressionoxidativestressOBJECTIVES:assessefficacyvsMETHODS:hospitalizedepisoderecruitedstudyrandomizedMembersfumarate50 mg/timetwice/dayincreased50-100 mgdaily300-600 mg/dreacheddosesplus10 mg/dadjusting20 mg/d1 weektreated8 weeksscoresHamiltonDepressionYoungManiaRatingRESULTS:Among6%participants50%score705%ParticipantsalsosignificantlysignificantCONCLUSION:Escitaloprameffectivecaneffectivelyimprovesymptomsinhibitbody'sinflammatoryresponseregulatestateriskmaniaQuetiapineeffectsinflammation

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