Effectiveness of Quetiapine as a Mood Stabilizer: A Case Series
Bibliographic record
Abstract
Introduction: Bipolar affective disorder (BD) had a chronic episodic course with recurrent episodes of mania or depression, leading to sociooccupational dysfunction.Standard pharmacology is dependent on conventional mood stabilizers, such as lithium, divalproex sodium, and carbamazepine.The role of atypical antipsychotics is more as a first-line adjunct in manic episodes.Recently, the evidence in Europe and America is favoring for use of Quetiapine as a primary mood stabilizer for all phases and episodes of bipolar illness and has even been incorporated in clinical practice guidelines of some countries, including the recent Canadian Network for Mood and Anxiety Treatment 2018 guidelines (CANMAT).However, the prescribing pattern of Indian Psychiatrists weighs heavily on time-tested conventional mood stabilizers during acute episodes as well as during maintenance phases.Methodology: In order to understand and assess the effectiveness of quetiapine as a monotherapy in any phase of bipolar affective disorder without compromising the standard of care and as per clinical requirements, quetiapine was instituted/switched to 14 patients of BD in any phase of illness.Results: Two patients in manic episode, four patients in depressive episode, and one patient in mixed episode attained complete remission with quetiapine monotherapy.Medications of six patients were successfully switched from conventional mood stabilizers to quetiapine monotherapy without any signs of relapse.One patient already maintaining remission on a combination of quetiapine and valproate was continued on the same regimen due to patient preference.All patients, whether in the acute phase or maintenance phase, were noted to be in remission on maintenance dosages of 300 mg/day.Conclusion: Quetiapine monotherapy is effective in acute phases and long-term stabilization of BD and is a welcome drug for the Indian population also.But our findings differed from CANMAT 2018 guidelines in that, quetiapine as a mood stabilizer in monotherapy appears to be more promising in the maintenance phase of BD and only as an adjunct for acute phase management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".