Quetiapine as add-on treatment for Bipolar I Disorder with comorbid compulsive buying and physical exercise addiction

Quetiapine is a second generation antipsychotic that shows affinity for various neurotransmitter receptors: specifically the D1 and D2 dopamine receptor, the alpha-1 and alpha-2 adrenergic receptor, and 5-HT1A and 5-HT2 serotonin receptor subtypes are antagonized. In the bipolar spectrum disorders quetiapine is approved for the treatment of acute manic and mixed episodes associated with bipolar I disorder. It is also approved for the treatment of acute bipolar depressive episodes and as adjunctive maintenance therapy of bipolar I disorder with lithium or valproate. In a previous study we reported the high frequency of association between bipolar disorder and behavioural addictions and the correlation with high level of impulsivity and specific temperamental and character dimensions. We underlined that the assessment of behavioural addictions in bipolar disorder patients may have a direct impact on the choice of pharmacological and psycho-educative interventions aimed at reducing harmful behaviours and the risk of relapses. The present case report deals with the potential use of quetiapine as add-on treatment for bipolar I disorder with comorbid compulsive buying and physical exercise addiction.