Quetiapine combined with escitalopram in the treatment of bipolar depression

Objectives To assess the efficacy of escitalopram combined with quetiapine vs quetiapine alone in the treatment of depressive episodes of bipolar disorder (BPD). Methods Eighty-eight hospitalized patients with a BPD depressive episode were recruited into the study. All patients were randomized to a control group (n = 44) or the intervention group (n = 44). Members of the control group received quetiapine fumarate alone, with an initial dose 50 mg twice/day; the dose was increased by 50-100 mg daily until 300-600 mg/d was reached. The treatment group received quetiapine at the same doses plus escitalopram, with the initial dose of escitalopram 10 mg/d, adjusting the dose to 20 mg/d after 1 week. Both groups were treated for 8 weeks. Scores on the Hamilton Depression Scale (HAMD) and Young Mania Rating Scale (YMRS), along with levels of IL-6, IL-1β, MIF, SOD, CAT, MDA and GSH-Px, were compared between groups. Results Among those in the intervention group, 88.6% of participants experienced a 50% or greater reduction in HAMD score compared to 70.5% in the control group ( P < .05). Participants in the intervention group also experienced a significantly greater reductions in IL-6, IL-1β, MIF and MDA levels ( P < .05), and a significant increase in SOD, CAT and GSH-Px levels compared to the control group ( P < .05). Conclusion Escitalopram oxalate combined with quetiapine is more effective than quetiapine alone in the treatment of patients with bipolar depressive episodes. This combination can effectively improve the symptoms of depression, inhibit the body’s inflammatory response, regulate the state of oxidative stress, and does not increase the risk of mania.