Quetiapine bests paroxetine in bipolar trial.

BARCELONA -- Quetiapine monotherapy edged out paroxetine monotherapy in a randomized placebo-controlled trial of patients with bipolar disorder.

By 8 weeks, quetiapine (Seroquel)--both 300 and 600 mg/day--reduced mean depression scores significantly more than did paroxetine (Paxil); the 600-mg dose also was associated with a significantly greater incidence of remission at 8 weeks than either the 300-mg dose or paroxetine 20 mg/day, Dr. Allan Young and his colleagues wrote in a poster presented at the annual congress of the European College of Neuropsychopharmacology.

The study randomized 700 patients with bipolar I or II disorder to either quetiapine 300 mg (229), quetiapine 600 mg (232), paroxetine 20 mg (118), or placebo (121).

By week 8, the mean score change from baseline on the Montgomery-Asberg Depression Rating Scale (MADRS) was significantly better in both quetiapine groups (-16) than in either the paroxetine (-14) or placebo groups (-13).

At that time, far more patients taking quetiapine met the criteria for response than did those taking paroxetine or placebo (67% vs. 53%).

Treatment-emergent side effects were more common among those taking quetiapine 300 or 600 mg than they were among those taking paroxetine.

The study was sponsored by Astra-Zeneca PLC. Dr. Young of the University of British Columbia, Vancouver, is a paid lecturer for the company and has received grants from it as well.