Antipsychotic Effects of Quetiapine in Naturalistic Long Term Follow Up Study
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ObjectiveaaThis study aimed to examine the effectiveness of quetiapine and the effects of dosage relates to its effectiveness on schizophrenia and schizoaffective disorder in a naturalistic setting in Korean people. MethodsaaThis study was a 24-week, open-label, non-comparative, naturalistic study of quetiapine in patients diagnosed with schizophrenia and schizoaffective disorder according to DSM-IV. We stratified the patients into mild [(clinical global impression severity (CGI-S)<4 at baseline)] and severe groups (CGI-S ≥4 at baseline). We investigated the response rate, defined as clinical global impression improvement (CGI-I) ≤2, in the severe group and the aggravation rate in the mild group using the last-observation-carried-forward (LOCF) and the Kaplan-Meier method (K-M). ResultsaaDuring the 24 weeks, 151 (18.4%) of the participants dropped out of the study. There was a significant decrease in the mean CGI-S score, from 4.5±1.1 at baseline to 2.8±1.1 at 24 weeks. The response rate of severe group was 54.5% (estimated by LOCF) and 73.3%(K-M estimated) at 24 weeks. All patients who completed the study had taken a mean quetiapine dosage of 507.9±245.9 mg daily. The decrease of CGI-S score in high-dose group (the maximum dose was 750 mg/d or above) was statistically significant than that in recommendeddose group (the maximum dose was less than 750 mg/d). ConclusionaaThis study demonstrated the long-term effectiveness of quetiapine in the treatment of schizophrenia and schizoaffective disorder in a naturalistic setting in Korean people. This study suggests that higher than recommended quetiapine dosages could be more effective in some patients.
Abstract
ObjectiveaaThis study aimed to examine the effectiveness of quetiapine and the effects of dosage relates to its effectiveness on schizophrenia and schizoaffective disorder in a naturalistic setting in Korean people. MethodsaaThis study was a 24-week, open-label, non-comparative, naturalistic study of quetiapine in patients diagnosed with schizophrenia and schizoaffective disorder according to DSM-IV. We stratified the patients into mild [(clinical global impression severity (CGI-S)<4 at baseline)] and severe groups (CGI-S ≥4 at baseline). We investigated the response rate, defined as clinical global impression improvement (CGI-I) ≤2, in the severe group and the aggravation rate in the mild group using the last-observation-carried-forward (LOCF) and the Kaplan-Meier method (K-M). ResultsaaDuring the 24 weeks, 151 (18.4%) of the participants dropped out of the study. There was a significant decrease in the mean CGI-S score, from 4.5±1.1 at baseline to 2.8±1.1 at 24 weeks. The response rate of severe group was 54.5% (estimated by LOCF) and 73.3%(K-M estimated) at 24 weeks. All patients who completed the study had taken a mean quetiapine dosage of 507.9±245.9 mg daily. The decrease of CGI-S score in high-dose group (the maximum dose was 750 mg/d or above) was statistically significant than that in recommendeddose group (the maximum dose was less than 750 mg/d). ConclusionaaThis study demonstrated the long-term effectiveness of quetiapine in the treatment of schizophrenia and schizoaffective disorder in a naturalistic setting in Korean people. This study suggests that higher than recommended quetiapine dosages could be more effective in some patients.
참고문헌 (23)
- Arvanitis LA, "Multiple fixed doses of “Seroquel” (quetiapine) in patients with acute exacerbation of schizophrenia: a comparison with haloperidol and placebo. The Seroquel Trial 13 Study Group", Biol Psychiatry, 42, pp.233~246 (1997)
- Borison RL, "ICI 204,636, an atypical antipsychotic: efficacy and safety in a multicenter, placebo-controlled trial in patients with schizophrenia. U.S. SEROQUEL Study Group", J Clin Psychopharmacol, 16, pp.158~169 (1996)
- Small JG, "Quetiapine in patients with schizophrenia. A high- and low-dose double-blind comparison with placebo. Seroquel Study Group", Arch Gen Psychiatry, 54, pp.549~557 (1997)
- Copolov DL, "A multicentre, double-blind, randomized comparison of quetiapine (ICI 204,636, ‘Seroquel’) and haloperidol in schizophrenia", Psychol Med, 30, pp.95~105 (2000)
- Emsley RA, "A comparison of the effects of quetiapine (‘seroquel’) and haloperidol in schizophrenic patients with a history of and a demonstrated, partial response to conventional antipsychotic treatment. PRIZE Study Group", Int Clin Psychopharmacol, 15, pp.121~131 (2000)
- Velligan DI, "Does cognitive function improve with quetiapine in comparison to haloperidol?", Schizophr Res, 53, pp.239~248 (2002)
- Bowden CL, "A randomized, double-blind, placebo-controlled efficacy and safety study of quetiapine or lithium as monotherapy for mania in bipolar disorder", J Clin Psychiatry, 66, pp.111~121 (2005)
- McIntyre RS, "Quetiapine or haloperidol as monotherapy for bipolar mania--a 12-week, doubleblind, randomised, parallel-group, placebo-controlled trial", Eur Neuropsychopharmacol, 15, pp.573~585 (2005)
- Altamura AC, "Quetiapine and classical mood stabilizers in the long-term treatment of Bipolar Disorder: a 4-year follow-up naturalistic study", J Affect Disord, 110, pp.135~141 (2008)
- Sachs G, "Quetiapine with lithium or divalproex for the treatment of bipolar mania: a randomized, double-blind, placebo-controlled study", Bipolar Disord, 6, pp.213~223 (2004)
- Vieta E, "Quetiapine monotherapy in the treatment of patients with bipolar I or II depression and a rapid-cycling disease course: a randomized, double-blind, placebo-controlled study", Bipolar Disord, 9, pp.413~425 (2007)
- McIntyre RS, "Quetiapine in the treatment of acute bipolar mania: efficacy across a broad range of symptoms", J Affect Disord, 100(1), pp.S5~S14 (2007)
- Ketter TA, "Rates of remission", euthymia with quetiapine monotherapy compared with placebo in patients with acute mania, 2007, pp.100(1), S45~S53
- Thase ME, "Efficacy of quetiapine monotherapy in bipolar I and II depression: a double-blind, placebo-controlled study (the BOLDER II study)", J Clin Psychopharmacol, 26, pp.600~609 (2006)
- Kahn RS, "Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial", Lancet, 371, pp.1085~1097 (2008)
- Mullins CD, "Risk of discontinuation of atypical antipsychotic agents in the treatment of schizophrenia", Schizophr Res, 98, pp.8~15 (2008)
- Haro JM, "Remission and relapse in the outpatient care of schizophrenia: three-year results from the Schizophrenia Outpatient Health Outcomes study", J Clin Psychopharmacol, 26, pp.571~578 (2006)
- Arango C, "Managing acute exacerbations of schizophrenia: focus on quetiapine", Curr Med Res Opin, 20, pp.619~626 (2004)
- Boggs DL, "Quetiapine at high doses for the treatment of refractory schizophrenia", Schizophr Res, 101, pp.347~348 (2008)
- 김진용, "정신증 환자의 증상과 기능에 대한 간략형 평가 척도의 타당도 및 신뢰도", 신경정신의학, 46(5), pp.492~498 (2007), 대한신경정신의학회
- Kerwin R, "A multicentre, randomized, naturalistic, open-label study between aripiprazole and standard of care in the management of communitytreated schizophrenic patients Schizophrenia Trial of Aripiprazole: (STAR) study", Eur Psychiatry, 22, pp.433~443 (2007)
- Wolf J, "A prospective, multicentre, open-label study of aripiprazole in the management of patients with schizophrenia in psychiatric practice in Europe: Broad Effectiveness Trial with Aripiprazole in Europe (EUBETA)", Curr Med Res Opin, 23, pp.2313~2323 (2007)
- Sparshatt A, "Quetiapine: dose-response relationship in schizophrenia", CNS Drugs, 22, pp.49~68 (2008)