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Quetiapine Holds Promise for Management of Aggressive Psychosis: Presented at CPA
By Donalee Moulton
HALIFAX, NS -- November 3, 2003 -- Quetiapine (Seroquel) holds considerable promise for the management of aggressive psychosis, suggest preliminary results from an open-label pilot study presented during the 53rd Annual Meeting of the Canadian Psychiatric Association, held October 30th to November 2nd in Halifax, Nova Scotia, Canada.
"The atypical antipsychotic quetiapine (Seroquel) has demonstrable efficacy in treating psychosis as well as a placebo-like incidence of extrapyramidal symptoms, including akathisia, across the entire dose range. It has been proposed that quetiapine may have some specific advantage with regard to the management of aggressive behaviour," state the researchers from the Psychiatric Assessment Unit, Vancouver General Hospital stated in their poster.
The efficacy and tolerability of quetiapine treatment was assessed in patients who presented at the Vancouver General Hospital's emergency psychiatric unit. Inclusion in the study required a minimum total score on the Overt Aggression Scale (OAS) 1 or greater and Brief Psychiatric Rating Scale psychosis index score of 6 or greater.
Patients in the study received 100 to 1000 mg/day of quetiapine for up to 5 days. No concomitant antipsychotic medication use was permitted during the study period.
Data for 38 patients has been analyzed so far. The mean period of treatment for this group was 4.1 days; 87% of participants completed at least 2 days of treatment and 47% completed the full 5 days. Diagnoses among these patients included unspecified psychosis in 45%, schizophrenia in 37% and substance abuse in 10%. Mean doses of quetiapine from Day 1 to Day 5 ranged from 208 to 385 mg, with increasing dosages over the 5-day period.
"Quetiapine treatment resulted in a 39% decrease in OAS score by Day 2 from a baseline of 3.3. The reduction in OAS score was statistically significant on each day after treatment was initiated," the researchers reported.
"Although this study was conducted in an emergency psychiatric setting, most patients were willing to take oral medication and quetiapine proved to be an appropriate choice," they added.
[Study title: Effectiveness of Quetiapine For The Treatment of Aggressive Psychosis In The Emergency Psychiatric Setting: A Naturalistic Pilot Study. Abstract P1-3]
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