Abstract
The aim of the present review was to discuss the following aspects of treatment with quetiapine in psychiatric disorders: i) Neurocognition and functional recovery in bipolar disorder (BD); ii) neuroprotective profile in different models; and iii) potential off-label indications. A PubMed search was conducted of articles published in English between 2000 and 2012 on quetiapine, cross-referenced with the terms ‘anxiety’, ‘attention deficit disorder’, ‘borderline personality disorder’, ‘dementia’, ‘insomnia’, ‘major depressive disorder’ (MDD), ‘obsessive-compulsive disorder’, ‘post-traumatic stress disorder’, ‘remission’, ‘cognition’, ‘neurobiology’, ‘neuroprotection’, ‘efficacy’ and ‘effectiveness’. Articles were selected from meta-analyses, randomized clinical trials and open trials, and the results were summarized. Quetiapine, when studied in off-label conditions, has shown efficacy as a monotherapy in MDD and general anxiety disorder. Quetiapine also appears to exhibit a small beneficial effect in dementia. The review of other conditions was affected by methodological limitations that precluded any definitive conclusions on the efficacy or safety of quetiapine. Overall, the present review shows evidence supporting a potential role for quetiapine in improving cognition, functional recovery and negative symptoms in a cost-effective manner in BD. These benefits of quetiapine are potentially associated with its well-described neuroprotective effects; however, further studies are clearly warranted.
Highlights
SOEIRO-DE-SOUZA et al: QUETIAPINE: FROM PSYCHIATRIC DISORDERS TO NEUROPROTECTION result of NET inhibition, the concentration of norepinephrine in the synapse increases, which, together with the increase in prefrontal dopamine and serotonin levels, could explain the efficacy of quetiapine as an antidepressant across several clinical trials [3,7]
Studies have shown that quetiapine is effective in reducing depressive symptoms both in monotherapy and in adjunctive therapy for patients with major depressive disorder (MDD) who have shown an inadequate response to antidepressant treatment [23,24,25,26,27]
This review has demonstrated that quetiapine has therapeutic potential for the treatment of several mental disorders
Summary
A PubMed search was conducted of articles published in English between January 1, 2000 and December 31, 2012 on quetiapine, cross‐referenced with the terms ‘anxiety’, ‘attention deficit disorder’, ‘borderline personality disorder’, ‘dementia’, ‘depression’, ‘insomnia’, ‘major depressive disorder’, ‘obsessive‐compulsive disorder’ and ‘post‐traumatic stress disorder’. The aim of the present study was to review the following aspects of treatment with quetiapine in psychiatric disorders: i) Neurocognition and functional recovery in BD; ii) neuroprotective profile in different models; and iii) potential indications. No improvement in cognition was observed following SGA treatment and no statistically significant differences were found between groups at the endpoint of the study [64] Overall, these RCTs indicate that quetiapine improves cognitive functioning in patients with schizophrenia; methodological heterogeneity (e.g. in recruited samples) across studies does not allow comparisons between quetiapine and other SGAs regarding cognitive effects. Quetiapine treatment has been associated with a significant increase in neuropeptide Y and a decrease in corticotropin‐releasing factor levels, and these changes predicted clinical response in patients with schizophrenia [23,24,25,26,27]. The present findings suggest an important role for quetiapine in the activation of neuroprotective pathways in diverse models, providing support to its therapeutic role in several psychiatric disorders
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