• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Quetiapine in Bipolar With OCD

Quetiapine in Bipolar With OCD

January 4, 2022
Richard Moldawsky, MD.
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Richard Moldawsky, MD. Dr. Moldawsky has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

REVIEW OF: Sahraian A et al, CNS Spectr 2021;1–5


TYPE OF STUDY: Randomized, double-blind, placebo-controlled clinical trial


SSRIs are first-line meds for obsessive-compulsive disorder (OCD), but they may pose risks of mania and rapid cycling when the patient also has bipolar disorder (BD). These conditions overlap more often than expected by chance, but only one controlled trial has looked at how to treat OCD in BD (it was positive and involved topiramate). This eight-week study tested quetiapine for obsessive-compulsive symptoms in patients with stable BD.


Participants had bipolar I with active OCD but were not in a mood episode. All were on lithium and clonazepam and no other psychotropics. Although they had no formal diagnosis of OCD, participants scored as moderate to severe (≥ 17) on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).


In total, 47 adults entered the study after excluding other psychiatric, substance use, and medical diseases. Forty completed the trial, of which half received placebo and half quetiapine. Doses were increased until symptoms resolved or patients couldn’t tolerate more. Patients completed standard clinician-rated scales for OCD (Y-BOCS), mania (Young Mania Rating Scale [YMRS]), and depression (Hamilton Depression Rating Scale [HDRS]) at weeks zero, four, and eight.


The Y-BOCS score was the main outcome measure. On average, it fell by 9.1 in the quetiapine group and 0.3 in the placebo group. Half of the quetiapine group had a significant response (> 34% decrease in Y-BOCS), compared with 5% of the placebo group. Average quetiapine dose was 325 mg, although the dose range wasn’t reported. All patients remained euthymic during the trial based on standard clinician-rated scales (YMRS and HDRS).


Of the 47 study participants, seven dropped out, none for reasons associated with quetiapine. Those on quetiapine were 2.3 times more likely to report side effects (eg, drowsiness, increased appetite, constipation, orthostasis).


TCPR’S TAKE
Although difficult to tolerate, quetiapine may help when OCD is causing significant impairment in patients with BD. It made a difference in this study, bringing Y-BOCS scores from moderate-severe to mild.

General Psychiatry
KEYWORDS antipsychotics bipolar_disorder co-occurring-disorders obsessive-compulsive-disorder ocd quetiapine
Richard Moldawsky, MD.

Brexpiprazole Ineffective in Mania

More from this author
www.thecarlatreport.com
Issue Date: January 4, 2022
SUBSCRIBE NOW
Table Of Contents
Working With Severe Personality Disorders
How to Use SAMe in Clinical Practice
The New Billing Codes
Quetiapine in Bipolar With OCD
CME Post-Test - The Difficult Patient, TCPR, January 2022
DOWNLOAD NOW
Featured Book
  • MFB6eCover.jpg

    Medication Fact Book for Psychiatric Practice, Sixth Edition (2022)

    Guidance, clinical pearls, and bottom-line assessments covering the medications you use in your...
    READ MORE
Featured Video
  • therapist_canstockphoto9201097.jpg
    General Psychiatry

    Using SAMe In Clinical Practice with Garrett Rossi, MD

    Read More
Featured Podcast
  • canstockphoto11543850.jpg
    General Psychiatry

    Elvis, Adderall, and a Broken Heart - Part 1

    A new medical investigation changes our understanding of Elvis Presley’s untimely death and offer some pearls for modern psychiatric practice.

    Listen now
Recommended
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png

About

  • About Us
  • CME Center
  • FAQ
  • Contact Us

Shop Online

  • Newsletters
  • Multimedia Subscriptions
  • Books
  • eBooks
  • ABPN Self-Assessment Courses

Newsletters

  • The Carlat Psychiatry Report
  • The Carlat Child Psychiatry Report
  • The Carlat Addiction Treatment Report
  • The Carlat Hospital Psychiatry Report
  • The Carlat Geriatric Psychiatry Report

Contact

info@thecarlatreport.com

866-348-9279

PO Box 626, Newburyport MA 01950

Follow Us

Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

© 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.