quetiapine-fumarate and Premenstrual-Syndrome

Premenstrual dysphoric disorder (PMDD), a more severe form of premenstrual syndrome (PMS), afflicts 5-8% of reproductive age women and results in significant functional impairment. We conducted a double-blind, placebo-controlled trial of adjunctive quetiapine in patients with PMS/PMDD who had inadequate response to selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor therapy for their symptoms.. A PMS/PMDD diagnosis was confirmed by 2-month prospective diagnostic assessment of PMS/PMDD using the Prospective Record of the Impact and Severity of Premenstrual Symptoms (PRISM) calendar. Women were randomized equally to receive quetiapine sustained-release (SR) or placebo (25-mg starting dose) during the luteal phase for 3 months. Outcome variables included the Hamilton Depression and Anxiety Scales, Clinical Global Impression Scale, and PRISM.. Twenty women were enrolled in the treatment phase. Although the study was underpowered, greater reductions in luteal phase mood ratings were observed in the quetiapine group on the 17-item Hamilton Depression Rating Scale, Clinical Global Impression improvement rating, and PRISM daily score. The quetiapine group showed most improvement in symptoms of mood lability, anxiety, and irritability.. This small double-blind study suggests that adjunctive treatment with quetiapine SR may be a useful addition to selective serotonin reuptake inhibitor therapy in women with PMS/PMDD by reducing symptoms and improving quality of life.

Topics: Adult; Antipsychotic Agents; Delayed-Action Preparations; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Pilot Projects; Premenstrual Dysphoric Disorder; Premenstrual Syndrome; Prospective Studies; Psychiatric Status Rating Scales; Quality of Life; Quetiapine Fumarate; Selective Serotonin Reuptake Inhibitors; Severity of Illness Index; Treatment Outcome

Exacerbation of symptoms in mood disorders such as bipolar disorders, major depressive disorders and premenstrual dysphoric disorders could be influenced by the hormonal changes of the menstrual cycles in female patients. Menarche has been related to onset of mood symptoms, which at times have been described as menstrual psychoses and could represent an early presentation of Pediatric bipolar disorders. Pediatric bipolar disorders appear to be characterized by less clearly defined mood episodes, shorter duration of these episodes, and different hallmark symptoms than in adults. This report describes a pediatric patient who had no previous psychiatric symptoms and for whom menstrual psychosis was the presenting symptom of bipolar disorder not otherwise specified.

Topics: Adolescent; Age of Onset; Anorexia; Antipsychotic Agents; Bipolar Disorder; Dibenzothiazepines; Estrogens; Female; Hallucinations; Humans; Menarche; Paranoid Disorders; Periodicity; Premenstrual Syndrome; Psychomotor Agitation; Quetiapine Fumarate; Sleep Initiation and Maintenance Disorders

A 40-year-old female patient with bipolar disorder and premenstrual dysphoric disorder did not present any physical evidence of virilization, treated with quetiapine and lithium carbonate. Laboratory testing showed evidence of hyperandrogenism (Testosterone levels 88.5ng/dL). After control, testosterone levels were normal (free testosterone 0.20 pg/ml, total testosterone 27.90ng/dl), as free thyroxine levels decreased (T4 0.83ng/dl) and increased progesterone levels (progesterone 3.80ng/ml). We consider an association between increased androgenic hormone levels in women, quetiapine and lithium carbonate treatment as well as the presence of an affective disorder and premenstrual dysphoric disorder. Some relevant patents are also outlined in this review.

Topics: Adult; Antimanic Agents; Antipsychotic Agents; Bipolar Disorder; Dibenzothiazepines; Female; Humans; Hyperandrogenism; Lithium Carbonate; Patents as Topic; Premenstrual Syndrome; Quetiapine Fumarate; Testosterone