ABSTRACT
Objective:To investigate the efficacy of quetiapine fumarate combined with lithium carbonate in the treatment of bipolar disorder and its effect on cognitive function.Methods:Sixty patients with bipolar disorder, who received treatment in Zhuji Fifth People's Hospital from January 2017 to December 2019, were included in this study. They were randomly assigned to receive either lithium carbonate (control group, n = 30) or quetiapine fumarate combined with lithium carbonate treatment (combined treatment group, n = 30). All patients received 4 weeks of treatment. Manic and depressive symptoms pre- and post-treatment, clinical efficacy, cognitive function, and adverse reactions were compared between the two groups. Fasting venous blood was taken before and 4 weeks after treatment to measure superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT), and glutathione peroxidase (GSH-Px) levels. Results:The scores of the Bech-Rafaelsdn Mania Rating Scale (BRMS) and the Hamilton Rating Scale for Depression (HAMD) in each group were significantly decreased after treatment compared with before treatment ( t = 10.39, 12.47, both P < 0.001). The score of the Mini-Mental State Examination in each group significantly increased after treatment compared with before treatment ( t = 8.36, 14.52, both P < 0.001). The scores of BRMS and HAMD post-treatment were significantly lower in the combined treatment group than in the control group ( t = 5.86, 5.54, both P < 0.001). The score of MMSE post-treatment was significantly higher in the combined treatment group than in the control group ( t = 2.40, P = 0.020). The response rate was significantly higher in the combined treatment group than in the control group ( Z = 2.16, P = 0.030). After treatment, serum MDA level significantly decreased in each group compared with before treatment ( t = 8.72, 15.47, both P < 0.001). After treatment, SOD, CAT and GSH-Px levels were significantly increased in each group compared with before treatment (SOD: tcontrol group = 2.84, P = 0.006, tcombined treatment group = 4.05, P < 0.001; CAT: tcontrol group = 5.20, P < 0.001, tcombined treatment group = 9.86, P < 0.001; GSH-Px: tcontrol group = 2.67, P = 0.010, tcombined treatment group = 3.71, P = 0.001). Serum MDA level post-treatment was significantly lower in the combined treatment group than in the control group ( t = 12.38, P < 0.001). Serum SOD and CAT levels post-treatment were significantly higher in the combined treatment group than in the control group ( tSOD = 2.24, P = 0.029; tCAT = 2.72, P = 0.009). There was no significant difference in the incidence of adverse reactions between the combined treatment and control groups [20.00% (6/30) vs. 16.67% (5/30), χ2 = 1.02, P = 0.907). Conclusion:Quetiapine fumarate combined with lithium carbonate can greatly improve clinical symptoms and cognitive function and reduce the over-activation of oxidative stress in patients with bipolar disorder. The combined therapy is of certain clinical application value.
ABSTRACT
Objective:To investigate the efficacy of magnesium valproate versus lithium carbonate in the treatment of bipolar disorder and their effects on serum indexes and quality of life. Methods:80 patients with bipolar disorder treated in the Fifth People's Hospital of Zhuji City from March 2017 to May 2020 were included in this study. They were randomly assigned to receive either lithium carbonate (control group, n = 40) or magnesium valproate (treatment group, n = 40) for 3 months. Efficacy,serum indexes, and quality of life were compared between the two groups. Results:Total effective rate was significantly higher in the observation group than in the control group [95.0% (38/40) vs. 75.0% (30/40), χ2 = 6.28, P = 0.012]. There were no significant differences in tumor necrosis factor-α, uric acid, total bilirubin, and albumin levels between the two groups (all P > 0.05). Tumor necrosis factor-α and uric acid levels in each group were decreased after treatment compared with before treatment (both P < 0.001). Total bilirubin and albumin levels in each group were increased after treatment compared with before treatment (both P < 0.001). Tumor necrosis factor-2 and uric acid levels measured after treatment were (136.5 ± 6.2) ng/L and (307.9 ± 15.2) μmol/L, respectively in the observation group, which were significantly lower than those in the control group [(148.9 ± 7.5) ng/L, (335.6 ± 18.9) μmol/L in the control group, t = 12.20, 7.22, both P < 0.001]. Total bilirubin and albumin levels measured after treatment were (11.0 ± 2.3) μmol/L and (45.5 ± 3.6) g/L, respectively in the observation group, which were significantly higher than those in the control group [(8.4 ± 2.1) μmol/L, (42.8 ± 3.0) g/L, t = 5.28, 3.64, both P < 0.001). There were no significant differences in scores of all dimensions of quality of life between the two groups before treatment (all P > 0.05). Scores of all dimensions of quality of life in each group increased after treatment compared with befor treatment (all P < 0.001). Scores of physical functioning, physical role functioning, bodily pain, vitality, social role functioning, emotional role functioning, and mental health measured after treatment were (75.2 ± 4.4) points, (71.9 ± 4.6) points, (76.2 ± 4.7) points, (71.8 ± 3.9) points, (66.8 ± 4.0) points, (75.9 ± 4.4) points, (70.5 ± 3.9) points, and (69.9 ± 4.0) points respectively in the observation group, which were significantly higher than those in the control group [(68.0 ± 4.0) points, (65.5 ± 4.3) points, (69.8 ± 4.0) points, (66.5 ± 3.5) points, (61.8 ± 3.5) points, (68.1 ± 4.0) points, (64.1 ± 3.6) points, (63.3 ± 3.9) points, t = 7.66, 6.43, 6.56, 6.40, 5.95, 8.30, 7.63, 7.47, all P < 0.001]. Conclusion:Magnesium valproate for the treatment of bipolar disorder can improve the antioxidant capacity, inhibit immune-inflammatory injury, improve abnormal metabolism, effectively control the symptoms of depression and mania,and improve the quality of life. Magnesium valproate is more effective than lithium carbonate in the treatment of bipolar disease.