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A double-blind randomized pilot study comparing quetiapine and divalproex for adolescent mania
Melissa P Delbello1, Robert A Kowatch1, Caleb M Adler1
1The authors are with the Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Summary
Quetiapine and divalproex showed similar overall efficacy for adolescent mania. However, quetiapine demonstrated a faster reduction in manic symptoms and higher response rates compared to divalproex.
Area of Science:
- Psychiatry
- Pharmacology
- Child and Adolescent Mental Health
Background:
- Adolescent mania requires effective treatment options.
- Comparative efficacy studies are crucial for guiding clinical decisions.
Purpose of the Study:
- To compare the efficacy of quetiapine and divalproex in treating adolescent mania.
- To assess the speed of symptom reduction and response/remission rates.
Main Methods:
- A 28-day double-blind study randomized 50 adolescents (12-18 years) with bipolar I disorder.
- Participants received either quetiapine (400-600 mg/day) or divalproex (serum level 80-120 microg/mL).
- The primary outcome was the change in Young Mania Rating Scale (YMRS) score.
Main Results:
- No significant overall difference in YMRS scores between groups (p = 0.3).
- Quetiapine showed a more rapid improvement in YMRS scores (p = 0.01-0.03).
- Higher response and remission rates were observed with quetiapine (p < .03); adverse events were similar.
Conclusions:
- Quetiapine is at least as effective as divalproex for acute adolescent mania.
- Quetiapine may offer a quicker reduction in manic symptoms.
- Quetiapine shows promise as monotherapy for adolescent manic/mixed episodes, pending placebo-controlled trials.
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