{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:24:21Z","timestamp":1770978261448,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"5p1","license":[{"start":{"date-parts":[[2006,10,16]],"date-time":"2006-10-16T00:00:00Z","timestamp":1160956800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2006,10]]},"abstract":"<jats:p><jats:bold>Objectives:\u2002<\/jats:bold> To evaluate extrapyramidal symptoms (EPS), including akathisia, with quetiapine in patients with bipolar mania.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> Data were analyzed from four similarly designed, randomized, double\u2010blind, 3\u2010 to 12\u2010week studies. Two studies evaluated quetiapine monotherapy (up to 800\u2003mg\/day) (n\u2003=\u2003209) versus placebo (n\u2003=\u2003198), with lithium or haloperidol monotherapy as respective active controls. Two studies evaluated quetiapine (up to 800\u2003mg\/day) in combination with a mood stabilizer (lithium or divalproex, QTP\u2003+\u2003Li\/DVP) (n\u2003=\u2003196) compared to placebo and mood stabilizer (PBO\u2003+\u2003Li\/DVP) (n\u2003=\u2003203). Extrapyramidal symptoms were evaluated using the Simpson\u2013Angus Scale (SAS), the Barnes Akathisia Rating Scale (BARS), adverse event reports and anticholinergic drug usage.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> The incidence of EPS\u2010related adverse events, including akathisia, was no different with quetiapine monotherapy (12.9%) than with placebo (13.1%). Similarly, EPS\u2010related adverse events with QTP\u2003+\u2003Li\/DVP (21.4%) were no different than with PBO\u2003+\u2003Li\/DVP (19.2%). Adverse events related to EPS occurred in 59.6% of patients treated with haloperidol (n\u2003=\u200399) monotherapy, whereas 26.5% of patients treated with lithium (n\u2003=\u200398) monotherapy experienced adverse events related to EPS. The incidence of akathisia was low and similar with quetiapine monotherapy (3.3%) and placebo (6.1%), and with QTP\u2003+\u2003Li\/DVP (3.6%) and PBO\u2003+\u2003Li\/DVP (4.9%). Lithium was associated with a significantly higher incidence (p\u2003&lt;\u20030.05) of tremor (18.4%) than quetiapine (5.6%); cerebellar tremor, which is a known adverse effect of lithium, may have contributed to the elevated rate of tremor in patients receiving lithium therapy. Haloperidol induced a significantly higher incidence (p\u2003&lt;\u20030.001) of akathisia (33.3% versus 5.9%), tremor (30.3% versus 7.8%), and extrapyramidal syndrome (35.4% versus 5.9%) than quetiapine. No significant differences were observed between quetiapine and placebo on SAS and BARS scores. Anticholinergic use was low and similar with quetiapine or placebo.<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> In bipolar mania, the incidence of EPS, including akathisia, with quetiapine therapy is similar to that with placebo.<\/jats:p>","DOI":"10.1111\/j.1399-5618.2006.00350.x","type":"journal-article","created":{"date-parts":[[2006,10,18]],"date-time":"2006-10-18T06:14:03Z","timestamp":1161152043000},"page":"467-474","source":"Crossref","is-referenced-by-count":18,"title":["Placebo\u2010level incidence of extrapyramidal symptoms (EPS) with quetiapine in controlled studies of patients with bipolar mania"],"prefix":"10.1111","volume":"8","author":[{"given":"Henry A","family":"Nasrallah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Brecher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn","family":"Paulsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,10,16]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"31","article-title":"Effects of clozapine therapy in schizophrenic individuals at risk for tardive dyskinesia","volume":"59","author":"Casey DE","year":"1998","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700038228"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004850-199501005-00005"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-977X(01)00109-2"},{"issue":"8","key":"e_1_2_6_6_2","first-page":"52","article-title":"Antipsychotic drug side effect issues in bipolar manic patients","volume":"61","author":"Zarate CA","year":"2000","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2005.00235.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.4.5.849"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.1.4.783"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.145.11.1455"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1185\/030079905X46340"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2004.00115.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000144887.66319.2f"},{"key":"e_1_2_6_14_2","first-page":"1","article-title":"Practice guidelines for the treatment of patients with bipolar disorder","volume":"159","author":"American Psychiatric Association","year":"2002","journal-title":"Am J Psychiatry"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.3109\/15622970209150612"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269881103017002003"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.182.2.141"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n0116"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2005.02.006"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1970.tb02066.x"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.154.5.672"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(97)00190-X"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1997.01830180067009"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-199600051-00004"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0010-440X(75)90019-X"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.142.4.499"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.neuropsych.13.3.336"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2000.101006452.x"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.157.9.1379"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1053\/comp.2001.24577"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-200306001-00003"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145700002042"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1988.01800330013001"},{"issue":"5","key":"e_1_2_6_34_2","first-page":"29","article-title":"Extrapyramidal side effects and tolerability of risperidone: a review","volume":"55","author":"Owens DGC","year":"1994","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.166.6.712"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200022030-00004"},{"key":"e_1_2_6_37_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.6.1057"},{"issue":"1","key":"e_1_2_6_38_2","first-page":"60","article-title":"Risperidone monotherapy in acute bipolar mania","volume":"5","author":"Khanna S","year":"2003","journal-title":"Bipolar Disord"},{"key":"e_1_2_6_39_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.7.1146"},{"key":"e_1_2_6_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2005.00219.x"},{"key":"e_1_2_6_41_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.9.1651"},{"key":"e_1_2_6_42_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.4.741"}],"container-title":["Bipolar Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1399-5618.2006.00350.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1399-5618.2006.00350.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T19:12:33Z","timestamp":1696878753000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1399-5618.2006.00350.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,10]]},"references-count":41,"journal-issue":{"issue":"5p1","published-print":{"date-parts":[[2006,10]]}},"alternative-id":["10.1111\/j.1399-5618.2006.00350.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1399-5618.2006.00350.x","archive":["Portico"],"relation":{},"ISSN":["1398-5647","1399-5618"],"issn-type":[{"value":"1398-5647","type":"print"},{"value":"1399-5618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,10]]}}}