Back to Journals » Drug Design, Development and Therapy » Volume 8

Quetiapine for acute bipolar depression: a systematic review and meta-analysis

Authors Suttajit S, Srisurapanont M, Maneeton N, Maneeton B

Received 8 March 2014

Accepted for publication 31 March 2014

Published 25 June 2014 Volume 2014:8 Pages 827—838


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Sirijit Suttajit, Manit Srisurapanont, Narong Maneeton, Benchalak Maneeton

Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Background: Precise estimated risks and benefits of quetiapine for acute bipolar depression are needed for clinical practice.
Objective: To systematically review the efficacy and the tolerability of quetiapine, either as monotherapy or combination therapy, for acute bipolar depression.
Methods: We included all randomized, controlled trials (RCTs) comparing quetiapine with other treatments, including placebo, in patients with acute bipolar depression (bipolar I or II disorder, major depressive episode). Published and unpublished RCTs were identified using the Cochrane Central Register of Controlled Trials, MEDLINE®, Web of Knowledge™, CINAHL®, PsycINFO®, the EU Clinical Trials Register database, and The primary outcome was the change scores of depression rating scales.
Results: Eleven RCTs (n=3,488) were included. Two of them were conducted in children and adolescents. The change in depression scores was significantly greater in the quetiapine group compared with the placebo group (mean difference, [MD] =-4.66, 95% confidence interval [CI] -5.59 to -3.73). The significant difference was observed from week 1. Compared with placebo, quetiapine had higher incidence rates of extrapyramidal side effects, sedation, somnolence, dizziness, fatigue, constipation, dry mouth, increased appetite, and weight gain but lower risks of treatment-emergent mania and headache. Quetiapine treatment was associated with significant improvement of clinical global impression, quality of life, sleep quality, anxiety, and functioning.
Conclusion: Quetiapine monotherapy is effective for acute bipolar depression and the prevention of mania/hypomania switching. Its common adverse effects are extrapyramidal side effects, sedation, somnolence, dizziness, fatigue, constipation, dry mouth, increased appetite, and weight gain. The lower risk of headache in quetiapine-treated patients with acute bipolar depression should be further investigated. The evidence for the use of quetiapine combined with mood stabilizers in children and adolescents with acute bipolar depression is too small to support the clinical practice.

Keywords: efficacy, side effects, response, remission, antipsychotic, dropout

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]