A randomized, double-blind, placebo-controlled trial of quetiapine in patients with bipolar disorder, mixed or depressed phase, and alcohol dependence

E. Sherwood Brown, Domingo Davila, Alyson Nakamura, Thomas J. Carmody, A. John Rush, Alexander Lo, Traci Holmes, Bryon Adinoff, Raul Caetano, Alan C. Swann, Prabha Sunderajan, Mary E. Bret

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Alcohol dependence is common in bipolar disorder (BPD) and associated with treatment nonadherence, violence, and hospitalization. Quetiapine is a standard treatment for BPD. We previously reported improvement in depressive symptoms, but not alcohol use, with quetiapine in BPD and alcohol dependence. However, mean alcohol use was low and a larger effect size on alcohol-related measures was observed in those with higher levels of alcohol consumption. In this study, efficacy of quetiapine in patients with BPD and alcohol dependence was examined in patients with higher mean baseline alcohol use than in the prior study. Methods: Ninety outpatients with bipolar I or II disorders, depressed or mixed mood state, and current alcohol dependence were randomized to 12 weeks of sustained release quetiapine (to 600 mg/d) add-on therapy or placebo. Drinking was quantified using the Timeline Follow Back method. Additional assessment tools included the Hamilton Rating Scale for Depression, Inventory of Depressive Symptomatology-Self-Report, Young Mania Rating Scale, Penn Alcohol Craving Scale, liver enzymes, and side effects. Alcohol use and mood were analyzed using a declining-effects random-regression model. Results: Baseline and demographic characteristics in the 2 groups were similar. No significant between-group differences were observed on the primary outcome measure of drinks per day or other alcohol-related or mood measures (p > 0.05). Overall side effect burden, glucose, and cholesterol were similar in the 2 groups. However, a significant weight increase was observed with quetiapine at week 6 (+2.9 lbs [SE 1.4] quetiapine vs. -2.0 lbs [SE 1.4], p = 0.03), but not at week 12. Scores on the Barnes Akathisia Scale increased significantly more (p = 0.04) with quetiapine (+0.40 [SE 0.3]) than placebo (-0.52 [SE 0.3]) at week 6 but not week 12. Retention (survival) in the study was similar in the groups. Conclusions: Findings suggest that quetiapine does not reduce alcohol consumption in patients with BPD and alcohol dependence.

Original languageEnglish (US)
Pages (from-to)2113-2118
Number of pages6
JournalAlcoholism: Clinical and Experimental Research
Volume38
Issue number7
DOIs
StatePublished - 2014

Fingerprint

Bipolar Disorder
Alcoholism
Placebos
Alcohols
Alcohol Drinking
Depression
Psychomotor Agitation
Quetiapine Fumarate
Violence
Self Report
Drinking
Hospitalization
Outpatients
Therapeutics
Cholesterol
Demography
Outcome Assessment (Health Care)
Weights and Measures
Glucose
Equipment and Supplies

Keywords

  • Alcohol dependence
  • Bipolar disorder
  • Depression
  • Mania
  • Quetiapine

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Toxicology
  • Medicine(all)

Cite this

A randomized, double-blind, placebo-controlled trial of quetiapine in patients with bipolar disorder, mixed or depressed phase, and alcohol dependence. / Sherwood Brown, E.; Davila, Domingo; Nakamura, Alyson; Carmody, Thomas J.; John Rush, A.; Lo, Alexander; Holmes, Traci; Adinoff, Bryon; Caetano, Raul; Swann, Alan C.; Sunderajan, Prabha; Bret, Mary E.

In: Alcoholism: Clinical and Experimental Research, Vol. 38, No. 7, 2014, p. 2113-2118.

Research output: Contribution to journalArticle

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abstract = "Background: Alcohol dependence is common in bipolar disorder (BPD) and associated with treatment nonadherence, violence, and hospitalization. Quetiapine is a standard treatment for BPD. We previously reported improvement in depressive symptoms, but not alcohol use, with quetiapine in BPD and alcohol dependence. However, mean alcohol use was low and a larger effect size on alcohol-related measures was observed in those with higher levels of alcohol consumption. In this study, efficacy of quetiapine in patients with BPD and alcohol dependence was examined in patients with higher mean baseline alcohol use than in the prior study. Methods: Ninety outpatients with bipolar I or II disorders, depressed or mixed mood state, and current alcohol dependence were randomized to 12 weeks of sustained release quetiapine (to 600 mg/d) add-on therapy or placebo. Drinking was quantified using the Timeline Follow Back method. Additional assessment tools included the Hamilton Rating Scale for Depression, Inventory of Depressive Symptomatology-Self-Report, Young Mania Rating Scale, Penn Alcohol Craving Scale, liver enzymes, and side effects. Alcohol use and mood were analyzed using a declining-effects random-regression model. Results: Baseline and demographic characteristics in the 2 groups were similar. No significant between-group differences were observed on the primary outcome measure of drinks per day or other alcohol-related or mood measures (p > 0.05). Overall side effect burden, glucose, and cholesterol were similar in the 2 groups. However, a significant weight increase was observed with quetiapine at week 6 (+2.9 lbs [SE 1.4] quetiapine vs. -2.0 lbs [SE 1.4], p = 0.03), but not at week 12. Scores on the Barnes Akathisia Scale increased significantly more (p = 0.04) with quetiapine (+0.40 [SE 0.3]) than placebo (-0.52 [SE 0.3]) at week 6 but not week 12. Retention (survival) in the study was similar in the groups. Conclusions: Findings suggest that quetiapine does not reduce alcohol consumption in patients with BPD and alcohol dependence.",
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AU - Davila, Domingo

AU - Nakamura, Alyson

AU - Carmody, Thomas J.

AU - John Rush, A.

AU - Lo, Alexander

AU - Holmes, Traci

AU - Adinoff, Bryon

AU - Caetano, Raul

AU - Swann, Alan C.

AU - Sunderajan, Prabha

AU - Bret, Mary E.

PY - 2014

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