A Clinical Trial Of The Efficacy And Safety Of Quetiapine And Aripiprazole In The Treatment Of Bipolar Depression

[BACKGROUND]Bipolar disorder is a kind of common disease of Psychiatry and it received special attention of psychiatrists due to the higher incidence,relapse rate,mutilate rate and lethality.The most patients of bipolar disorder were spent more time on depressive state than on mania state.Several atypical antipsychotic agnets are applied in the treatment of bipolar disorder gradually besides typical mood stabilizers.The primary purpose of this research is to explore the efficacy and safety of quetiapine and aripiprazole in the treatment of acute bipolar depression.[OBJECTIVE]To explore the efficacy and safety of quetiapine and aripiprazole in the treatment of bipolar depression.To evaluate the sleep quality of patients before and after the treatment.[METHODS]A total of 69 patients with CCMD-3 bipolar disorder experiencing a depressive episode,a aged 18 to 60 years old,were randomly assigned to 2 groups.The quetiapine group(n=35) was treated with quetiapine 50～300mg/d and the aripiprazole group(n=34) was treated with aripiprazole 10mg/d for 8 weeks.Basic information questionnaire was administrated to all subjects,Patients in to groups have no significant difference in age,sex, education level,civil state,family income,total course of disease and present course of disease(P＞0.05).The measures include the Montgomery-Asberg Depression Rating Scale(MADRS),Bech-Rafaelsen Mania Rating Scale (BRMS),Treatment Emergent Symptom Scale(TESS) and Pittsburgh Sleep Quality Index(PSQI).Finally we input the information to computer and analyzed with statistical software of SPSS 11.5.[RESULTS]Curative effect:1.To analysis the total score of MADRS and effective power:1) To compare the total score of MADRS:The total score of MADRS of patients reduced significantly from baseline to week 2,4,6,8 in quetiapine group (P＜0.01).Patients in aripiprazole group also has significante reduction in total score of MADRS(P＜0.01).They had no significant differences between 2 groups in total score of MADRS after treatment(P＞0.05).2) To compare the effective power:2 groups showed no significant differences in effective power in the week 2,4,6,8(P＞0.05).2.To analyze the sleep quality:After the evaluation of PSQI,the total score of PSQI in quetiapine group was reduced significantly than at baseline from week 2(P＜0.05) while the reduction in aripiprazole group was from week 4(P＜0.05).The total score of PSQI between the 2 groups showed significant differences just in week 8(P＜0.05)Safety:3.To analyze the adverse effect rate:We use TESS to evaluate the adverse effect occurred in all patients.The adverse effect rate in quetiapine group and aripiprazole group were 20.0%and 32.4%,2 groups showed no significant differences in adverse effect rate(P＞0.05).4.To analyze the add lorazepam:A total of 38(55.1 percent) patients in 2 groups added lorazepam to resolve anxiety or sleeping disturbance with 12(34.3 percent) in quetiapine group and 26(76.5 percent) in aripiprazole group,2 groups showed significant difference in usage rate(P＜0.001).[CONCLUSION]1.Quetiapine and aripiprazole are efficiently in the treatment of bipolar depression;2.Quetiapine and aripiprazole with mild adverse are safe for patients and rare serious adverse events can occur in the 2 groups;3.Sleep quality in both quetiapine group and aripiprazole group are improved significantly;...