Document Detail

Neurochemical effects of quetiapine in patients with bipolar mania: a proton magnetic resonance spectroscopy study.
MedLine Citation:
PMID:  23764689     Owner:  NLM     Status:  MEDLINE    
Although the neurophysiology underlying pharmacotherapy for bipolar disorder remains poorly understood, recent studies suggest that therapeutic mechanisms may be reflected in changes in concentrations of N-acetylaspartate (NAA), a putative measure of neuronal integrity and metabolism. In this study, we used magnetic resonance spectroscopy (MRS) to examine prefrontal NAA in patients receiving quetiapine for bipolar mania. On the basis of previous findings, we hypothesized that remission would be associated with increased NAA concentrations in the prefrontal cortex. Thirty-one manic bipolar patients and 13 healthy subjects were recruited to participate in this prospective study. All subjects participated in MRS at baseline and after 8 weeks of treatment. Bipolar subjects received open-label quetiapine monotherapy (mean dose [SD], 584 [191] mg). Fourteen patients remitted (Young Mania Rating Scale ≤ 12) ("remitters"), 11 patients did not ("nonremitters"), and 6 patients were lost to follow-up. Bipolar and healthy subjects did not significantly differ in baseline NAA or degree of change during the 8 weeks. Remitters showed greater mean baseline NAA concentrations in the right ventrolateral prefrontal cortex compared with nonremitters (P < 0.05). In the anterior cingulate, remitters showed near significantly decreased baseline NAA concentrations at baseline (P < 0.06), and significant differences in NAA change during the 8 weeks of treatment (P < 0.03). Manic patients who remitted with quetiapine treatment in the course of this study exhibited distinct patterns of baseline prefrontal NAA concentration, coupled with decreased NAA in the anterior cingulate with treatment; the latter possibly reflecting disparate effects of quetiapine on neuronal metabolism. These data support suggestions that therapeutic effects of quetiapine involve metabolic effects on specific prefrontal regions.
Caleb M Adler; Melissa P DelBello; Wade A Weber; Kelly B Jarvis; Jeffrey Welge; Wen-Jang Chu; Emily Rummelhoff; Mi-Jung Kim; Jing-Huei Lee; Stephen M Strakowski
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical psychopharmacology     Volume:  33     ISSN:  1533-712X     ISO Abbreviation:  J Clin Psychopharmacol     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-01     Completed Date:  2014-02-18     Revised Date:  2014-05-02    
Medline Journal Info:
Nlm Unique ID:  8109496     Medline TA:  J Clin Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  528-32     Citation Subset:  IM    
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MeSH Terms
Antipsychotic Agents / therapeutic use*
Aspartic Acid / analogs & derivatives*,  metabolism
Biological Markers / metabolism
Bipolar Disorder / diagnosis,  drug therapy*,  metabolism,  psychology
Case-Control Studies
Dibenzothiazepines / therapeutic use*
Gyrus Cinguli / drug effects,  metabolism
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy*
Middle Aged
Prefrontal Cortex / drug effects*,  metabolism
Prospective Studies
Remission Induction
Time Factors
Treatment Outcome
Young Adult
Grant Support
Reg. No./Substance:
0/Antipsychotic Agents; 0/Biological Markers; 0/Dibenzothiazepines; 30KYC7MIAI/Aspartic Acid; 997-55-7/N-acetylaspartate; BGL0JSY5SI/quetiapine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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