Agitation and aggressive behavior are common symptoms in patients with an acute relapse of bipolar mania.

Quetiapine XR is an effective treatment in agitated patients with an acute relapse of bipolar disorder.

The aim of this study was to assess the efficacy and tolerability of Quetiapine XR in patients with manic episode.

This naturalistic, observational study evaluated 45 patients diagnosed with manic episode, bipolar disorder I (DSM IV-TR) for a period of 4 weeks, during which the patients received Quetiapine XR, in doses between 800 mg and 1000 mg per day, using a rapid titration scheme.

Efficacy of the treatment was measured using Young Mania Rating Scale (YMRS) and Clinical Global Impression Scale (CGI), performed at baseline, and then weekly. The Overt Aggression Scale-Modified (OAS-M) was used daily until day 4 and then once per week. Extrapyramidal symptoms were assessed with Barnes Akathisia Rating Scale and Abnormal Involuntary Movement Scale.

Important improvement of OAS-M total score was observed from the second day of treatment. After 4 weeks, more than a half of the patients presented a decrease of YMRS score with more than 50%. The CGI score also significantly improved. The treatment was well tolerated, mild to moderated adverse reactions being registered, without extrapyramidal symptoms.

These results confirm that Quetiapine XR is an effective and safe treatment for patients with an acute relapse of bipolar disorder I, the rapid titration scheme of the doses leading to a good control of aggressive behavior.