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A randomized pilot study of psychotherapy and quetiapine for the acute treatment of bipolar II depression
Author(s) -
Swartz Holly A,
Frank Ellen,
Cheng Yu
Publication year - 2012
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2012.00988.x
Subject(s) - quetiapine , mania , bipolar disorder , psychology , mood , depression (economics) , clinical psychology , young mania rating scale , psychiatry , hamilton rating scale for depression , randomized controlled trial , rating scale , interpersonal psychotherapy , bipolar ii disorder , bipolar i disorder , medicine , major depressive disorder , schizophrenia (object oriented programming) , developmental psychology , economics , macroeconomics
Swartz HA, Frank E, Cheng Y. A randomized pilot study of psychotherapy and quetiapine for the acute treatment of bipolar II depression. Bipolar Disord 2012: 14: 211–216. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S. Objectives: The differential roles of psychotherapy and pharmacotherapy in the management of bipolar (BP) II depression are unknown. As a first step toward exploring this issue, we conducted a pilot study to evaluate the feasibility and acceptability of comparing a BP‐specific psychotherapy [Interpersonal and Social Rhythm Therapy (IPSRT)] to quetiapine as treatments for BP‐II depression. Methods: Unmedicated individuals (n = 25) meeting DSM‐IV criteria for BP‐II disorder, currently depressed, were randomly assigned to weekly sessions of IPSRT (n = 14) or quetiapine (n = 11), flexibly dosed from 25–300 mg. Participants were assessed with weekly measures of mood and followed for 12 weeks. Treatment preference was queried prior to randomization. Results: Using mixed effects models, both groups showed significant declines in the 25‐item Hamilton Rating Scale for Depression [ F (1,21) = 44, p < 0.0001] and Young Mania Rating Scale [ F (1,21) = 20, p = 0.0002] scores over time but no group‐by‐time interactions. Dropout rates were 21% (n = 3) and 27% (n = 3) in the IPSRT and quetiapine groups, respectively. Overall response rates (defined as ≥ 50% reduction in depression scores without an increase in mania scores) were 29% (n = 4) in the IPSRT group and 27% (n = 3) in the quetiapine group. Measures of treatment satisfaction were high in both groups. Treatment preference was not associated with outcomes. Conclusions: Outcomes in participants with BP‐II depression assigned to IPSRT monotherapy or quetiapine did not differ over 12 weeks in this small study. Follow‐up trials should examine characteristics that predict differential response to psychotherapy and pharmacotherapy.