Administration Of Quetiapine Research Articles

Relevance of therapeutic drug monitoring (TDM) in patients with quetiapine administration

Introduction: Quetiapine is a new atypical antipsychotic agent,the relevance of TDM is still discussed.

Quetiapine and Gabapentin Dramatically Improve Treatment-resistant Schizoaffective Disorder in a Patient With a Long History of Cocaine Abuse

Objective: To describe the successful use of quetiapine and gabapentin in a patient with treatment-resistant schizoaffective disorder and comorbid crack cocaine addiction. Case Report: This case report describes a 34-year-old man with a history of schizoaffective disorder, depression, and cocaine addiction. After numerous suicide attempts, repeated hospitalizations, and treatment with various conventional and atypical antipsychotics over a 10-year period, the patient showed dramatic improvement on a combination of quetiapine 800 mg/d and gabapentin 1200 mg/d. Over a 5-month period, his mood stabilized; he became less paranoid; he was able to cope better with his auditory hallucinations; and he had no cravings for crack cocaine. In addition, the concomitant administration of quetiapine and gabapentin in this patient caused no adverse events. Conclusion: The concomitant use of quetiapine and gabapentin may have beneficial effects in patients with schizo-affective disorder and comorbid cocaine addiction refractory to other medications. Controlled clinical trials are needed to confirm these findings.

Quetiapina y ziprasidona en el tratamiento de los trastornos psicóticos de la enfermedad de Parkinson

As neurologists we often find it necessary to use antipsychotics in our clinical practice. They are not only used in the treatment of the behavioural disorders accompanying dementias, but also in the psychotic symptoms that frequently appear or complicate the clinical progress of our patients suffering from Parkinson. Taking into account the numerous side effects of the typical antipsychotic drugs, we began a prospective study on the use of a new antipsychotic agent, quetiapine, in the treatment of 134 patients with Parkinson's disease who presented signs or symptoms of parkinsonian psychosis at some time during the course of their clinical progression; results were analysed at three and six months. At the same time, we review the efficacy of another antipsychotic agent, ziprasidone, which from the chemical point of view fulfils a profile that suits the needs of our patients. At the time of writing this paper we have recorded 43 cases of patients with Parkinson's disease and concomitant parkinsonian psychoses, which responded adequately to treatment without any kind of side effects. The administration of quetiapine in doses of 25-50 mg/day brought about an important improvement in the control over the signs of parkinsonian psychoses in our patients. The same occurred with the administration of 20-40 mg/day of ziprasidone. Both drugs were found to be extremely well tolerated and of great clinical value in the treatment of this clinical entity. Both quetiapine and ziprasidone are drugs that can be of great value in the treatment of parkinsonian psychoses. In addition to their high degree of clinical effectiveness, they also have a broad safety profile and no side effects.

Stereotyped behaviors or punding after quetiapine administration in Parkinson's disease

Quetiapine has been suggested to be useful for the treatment of psychosis in patients with Parkinson's disease without prominent deterioration of motor functions. We present two patients with Parkinson's disease in whom administration of quetiapine for drug-induced psychosis caused characteristic stereotyped behaviors or punding. Since stereotyped behaviors are usually associated with excessive dopaminergic activity, it is clinically important to note that stereotyped behaviors or punding may be induced by an atypical antipsychotic drug for the treatment of psychosis in patients with Parkinson's disease.

Effects of quetiapine on gonadal axis hormones in male patients with schizophrenia: a preliminary, open study

Purpose: The authors investigated the effects of a novel antipsychotic agent, quetiapine administration on hypothalamo-pituitary-gonadal (HPG) axis hormones in patients with chronic schizophrenia. Methods: In this prospective, open-label study, the subjects were nine male inpatients. We tried to switch the patients from typical antipsychotics to quetiapine. The patients took a mean dose of 636.1 mg quetiapine daily for a mean period of 104.7 days. Results: (i) Although the total Brief Psychiatric Rating Scale score did not show significant changes, no patients needed anticholinergic medications after the switch. (ii) Before the switch, only the prolactin concentration showed a significant difference between the patients and normal subjects. After the switch, neither prolactin nor HPG axis hormone concentrations showed significant differences between the groups. Conclusions: Our preliminary results indicated that quetiapine might not affect prolactin and HPG axis hormones at least in chronic schizophrenia patients with normal levels of HPG axis hormones.

Clinical experience of quetiapine in 24 elderly patients with delirium

AbstractBackground: A recent study reported that patients with delirium responded well to the administration of atypical antipsychotic agents. In the present study we administered quetiapine to patients with delirium and obtained good results.Methods: This study included 24 patients (10 men, 14 women), referred to the psychiatry department during admission to other hospital departments, who were diagnosed as having delirium according to the diagnostic and statistical manual of mental disorders (4th edition) (DSM‐IV) between April 2001 and September 2002. The mean age of the patients was 76.5 years (men 71.0 years; women 80.5 years). An initial dose of quetiapine was established at 25–50 mg/day. Depending on the symptoms, the dose and frequency were increased as required. According to Trzepacz's delirium rating scale (DRS), the treatment response was evaluated prior to the administration of quetiapine and 1, 3, 5 and 7 days after administration began.Results: Prior to the administration of quetiapine, the mean DRS score was 18.1. The mean scores were 12.2, 10.8, 9.7 and 8.9 after 1, 3, 5 and 7 days of quetiapine administration, respectively. These values were significantly lower than the value before administration (P < 0.001). Seven days after the administration of quetiapine commenced, the total DRS score was lower than the cutoff point (12) in 20 patients (83.3%). In 18 patients (75.0%), delirium was clinically relieved. Doses ranged from 25 mg/day to 125 mg/day, with a mean dose of 54.7 mg/day. With respect to the administration method, the majority of patients (i.e. 13 patients) received quetiapine once per day (after dinner). Somnolence was observed in three patients as a side‐effect of quetiapine administration. However, this side‐effect improved after 1–2 days, without decreasing the dose.Conclusions: Quetiapine may be useful for controlling delirium and concerning side‐effects and extrapyramidal symptoms were not recorded in the present study. Thus, it is appropriate to trial quetiapine in the treatment of delirium.

Random-assignment, double-blind, clinical trial of once- versus twice-daily administration of quetiapine in patients with schizophrenia or schizoaffective disorder

Random-assignment, double-blind, clinical trial of once- versus twice-daily administration of quetiapine in patients with schizophrenia or schizoaffective disorder

Effect of prenatal administration of haloperidol, risperidone, quetiapine and olanzapine on spatial learning and retention in adult rats

The typical antipsychotic haloperidol and atypical antipsychotics olanzapine, quetiapine and risperidone were administered to pregnant Sprague–Dawley dams in the drinking water from Days 8 to 18 of gestation. When the offspring reached adulthood (2 months), spatial learning and short-term retention were examined using the radial arm maze. Results showed that prenatal administration of haloperidol, risperidone and quetiapine impaired learning but only haloperidol and risperidone disrupted short-term retention.

Dosing and switching strategies for quetiapine fumarate

Background: The atypical antipsychotic agent quetiapine fumarate has demonstrated efficacy and tolerability in clinical trials in patients with chronic or subchronic exacerbations of schizophrenic symptoms. Objective: This review summarizes clinical trial data and other practical information regarding the initiation and routine administration of quetiapine. Appropriate strategies for switching from other antipsychotic agents to quetiapine are also discussed. Results: Quetiapine is an appropriate initial treatment for psychotic disturbances in patients with schizophrenia of any stage and for those in whom a therapeutic switch is indicated for clinical reasons, such as inability to tolerate the side effects of treatment. Titration to 400 mg/d is recommended using the following schedule, administered BID in divided doses: day 1, 50 mg; day 2, 100 mg; day 3, 200 mg; day 4, 300 mg; and day 5, 400 mg. In patients who respond to quetiapine, therapy should be continued at the optimal dose that maintains remission, within the range of 150 to 750 mg/d. When a change in therapy is indicated, several strategies for switching from one antipsychotic agent to another may be applied to switching to quetiapine. Whereas studies have shown that an abrupt switch to or withdrawal from quetiapine does not produce significant clinical consequences, in practice the switch should be carefully individualized to minimize the potential for psychotic relapse or development of withdrawal symptoms. Conclusions: Quetiapine has antipsychotic effects and good tolerability at doses from 150 to 750 mg/d. Patients can be switched to quetiapine and their treatment individualized to achieve the optimal therapeutic effect with a minimum of dose-limiting side effects. There are several strategies for switching to quetiapine from another antipsychotic agent that do not appear to cause significant exacerbation of psychosis or withdrawal reactions.

Quetiapine attenuates the immobilization stress-induced decrease of brain-derived neurotrophic factor expression in rat hippocampus

Quetiapine is a new atypical antipsychotic drug widely used in the treatment of schizophrenia and other psychotic disorders. This study examined the influence of quetiapine on the decrease of brain-derived neurotrophic factor (BDNF) expression, induced by chronic immobilization stress, in the hippocampus of the rat. Pretreatment with 10 mg/kg of quetiapine markedly attenuated the stress-induced decrease in levels of BDNF protein, as determined by Western blot analyses, and the reduction of BDNF immunoreactivity, in hippocampal pyramidal and dentate granular neurons. These results suggest that the chronic administration of quetiapine could be neuroprotective to hippocampal neurons in schizophrenia and this effect may be related to its antipsychotic effect in patients with schizophrenia.

Long-term use of quetiapine in elderly patients with psychotic disorders

Background Quetiapine is an atypical antipsychotic agent that does not appear to increase patient risk for treatment-emergent extrapyramidal symptoms (EPS) or anticholinergic symptoms. Previous studies of quetiapine use in elderly patients with schizophrenia and other psychoses examined short-term administration (≤12 weeks). Given the growing elderly population, the commensurate increase in elderly patients with psychoses, and the expected increase in disease treatment-years, the effect of long-term quetiapine administration in older patients is of considerable interest. Objective: This study assesses the long-term tolerability, safety, and clinical benefit of quetiapine in elderly patients with psychosis. Methods Elderly patients (≥65 years of age) with psychotic disorders, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, participated in this 52-week, open-label, multicenter trial. Investigators increased (and later adjusted) daily doses of quetiapine on the basis of clinical response and tolerability, and assessed safety and efficacy. Efficacy assessments were made using the 18-item Brief Psychiatric Rating Scale (BPRS), Clinical Global Impressions (CGI), Simpson-Angus Scale, and the Abnormal Involuntary Movement Scale (AIMS). For patients who withdrew before week 52, analyses were performed using observed data and the last observation carried forward. Results One hundred eighty-four patients with psychotic disorders (98 women and 86 men) with a mean age of 76.1 years entered the trial. Seventy-two percent had psychotic disorders due to general medical conditions such as Alzheimer's disease, and 28% had other psychotic disorders, most commonly schizophrenia. Overall, 89 (48%) patients completed treatment through 52 weeks. Median total daily dose was 137.5 mg. Reasons for withdrawal included lack of efficacy (19%), adverse events or intercurrent illness (15%), failure to return for follow-up (13%), protocol noncompliance (3%), and diminished need for treatment (2%). Somnolence (31%), dizziness (17%), and postural hypotension (15%) were common adverse events, but they rarely resulted in withdrawal from therapy. EPS-related adverse events occurred in 13 % of patients. At end point (week 52), mean total score on the Simpson-Angus Scale had decreased from baseline by 1.8 points, whereas changes in AIMS scores were negligible. No clinically important effects were reported relative to mean changes in hematologic, thyroid function, or hepatic function variables. Quetiapine treatment appeared to have no associated cardiovascular adverse outcomes despite cardiovascular comorbidities and unrestricted use of concomitant cardiovascular medications. Significant decreases in BPRS total score (n = 170, P < 0.001) and CGI Severity of Illness item score (n = 177, P < 0.002) were seen at end point (observed data and last observation carried forward). Decreases of ≥20% in mean BPRS total score were observed in 83 (49%) patients. Conclusions These results provide preliminary information to clinicians regarding tolerability, safety, and clinical improvement with quetiapine in elderly patients with psychotic symptoms, and support controlled studies of quetiapine in this patient population.

Heat production in the brown adipose tissue by CGRP injection into the ventromedial hypothalamic nucleus

Since no experiment regarding a possible relation between quetiapine and orexin A has been reported in international literature, this experiment tested the effect of quetiapine on the sympathetic and thermogenic effects induced by orexin A. The firing rates of the sympathetic nerves to interscapular brown adipose tissue (IBAT), along with IBAT, colonic temperatures and heart rate were monitored in urethane-anesthetized male Sprague-Dawley rats before an injection of orexin A (1.5 nmol) into the lateral cerebral ventricle and over a period of 150 min after the injection. The same variables were monitored in rats with an intraperitoneal administration of quetiapine (5 or 10 mg/kg bw), injected 30 min before the orexin administration. The results show that orexin A increases the sympathetic firing rate, IBAT, colonic temperatures and heart rate. This increase is delayed or reduced by the injection of quetiapine. These findings indicate that quetiapine affects the complex reactions related to activation of orexinergic system. Possible influences on the control of body weight and temperature are discussed.

Quetiapine : A Review of its Use in Schizophrenia.

Quetiapine : A Review of its Use in Schizophrenia.