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

Drug Safety - Case Reports Pub Date : 2017-10-23 DOI:10.1007/s40800-017-0057-9

C Rovera, C M Esposito, V Ciappolino, D Cattaneo, S Baldelli, E Clementi, A C Altamura, M Buoli

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引用次数: 4

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.

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奎硫平引起的轻度躁狂及其与奎硫平/去甲奎硫平血浆浓度的关系:双相2型患者的病例系列

国际指南认为中等剂量喹硫平(300- 400mg /天)是治疗双相抑郁症的有效选择，因为与抗抑郁药相比，它转换为轻躁/躁狂的风险更低。去甲喹硫平是一种具有抗抑郁作用的活性代谢物。我们描述了三例双相2型受试者接受奎硫平缓释单药治疗(300 mg/天)轻/中度重度抑郁发作的诱发性轻躁狂病例。治疗1周后测定喹硫平和去甲喹硫平血药浓度。喹硫平缓释单药治疗7-10天后出现轻度躁狂，所有受试者均有喹硫平/去甲喹硫平血药浓度比

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Drug Safety - Case Reports

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