Clinical efficacy of quetiapine combined with lithium carbonate in the treatment of manic episodes of bipolar disorder
Objective:To investigate the effects of quetiapine combined with lithium carbonate on clinical symptoms and cognitive function in manic episodes of bipolar disorder.Methods:89 patients with manic episodes of bipolar disorder admitted to the department of mood disorders in our hospital between January 2020 and August 2023 were randomly divided into a control group(44 patients)and a study group(45 patients).The control group was administered olanzapine and lithium carbonate.The initial dose of lithium carbonate was 500 mg/day,twice a day,and the maintenance dose was 500～1 500 mg/d,twice a day.The initial dose of olanzapine was 5 mg/day once a day,and the maintenance dose was 5～20 mg/day,once or twice a day.The study group was treated with quetiapine and lithium carbonate,and the usage and dosage of lithium carbonate were the same as those in the control group.The initial dose of quetiapine fumarate was 50 mg/time,twice a day,and the maintenance dose was 300～600 mg/d,twice a day.After eight weeks,serum superoxide dismutase(SOD),tumor necrosis factor-α(TNF-α),Baker-Raphson Mania Scale(BRMS),Positive and Negative Symptom Scale(PANSS),Wechsler Adult Intelligence Scale(WAIS-RC),Mini Mental State Examination Scale(MMSE),and the incidence of adverse reactions were compared between the two groups.Results:There were no statistically significant differences in SOD and TNF-α levels between the two groups before treatment(P＞0.05).After eight weeks of treatment,SOD and TNF-α levels in the two groups were significantly lower than before treatment(P＜0.05),and the levels in the study group were significantly lower than those in the control group(P＜0.05).There was no significant difference in the BRMS and PANSS scores between the two groups before treatment(P＞0.05).After eight weeks of treatment,the BRMS and PANSS scores of the two groups were significantly lower than those before treatment(P＜0.05),and the BRMS scores of the study group were significantly lower than those of the control group(P＜0.05),but there was no significant difference between the two groups(P＞0.05).There was no significant difference in the WAIS-RC and MMSE scores between the two groups before treatment(P＞0.05).After eight weeks of treatment,the WAIS-RC and MMSE scores of the two groups were significantly higher than those before treatment(P＜0.05),but there was no statistical difference between the two groups(P＞0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Olanzapine combined with lithium carbonate and quetiapine combined with lithium carbonate can alleviate the clinical symptoms and cognitive function of patients with manic episodes of bipolar disorder,reduce the inflammatory level,and reduce adverse reactions.The combination of quetiapine and lithium carbonate is beneficial for reducing the stress response and relieving positive symptoms.Clinically,the medication scheme can be reasonably selected according to the actual situation of the patients.
quetiapinelithium carbonatebipolar disordermanic episodesclinical symptomscognitive function
万方数据
维普
