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Quetiapine Treatment for Post-traumatic Stress Disorder: A Systematic Review of the Literature

Calogero Crapanzano|Ilaria Casolaro|Chiara Amendola|Stefano Damiani
대한정신약물학회 (Korean College of Neuropsychopharmacology)|2023.02|Clinical Psychopharmacology and Neuroscience|제21권 제1호|pp. 49-56|DOI 10.9758/cpn.2023.21.1.49

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참고문헌

키워드

PTSDDrug resistancePharmacotherapy.Quetiapine

초록

Paroxetine and Sertraline are the only medications approved in posttraumatic stress disorder (PTSD). However, about 60% of traumatized patients fail to show an adequate clinical response. Second generation antipsychotics are recommended as second-line monotherapy or third-line augmentation strategies and quetiapine appears as one of the most used and promising agents. Up to date, no reviews assessed the efficacy of quetiapine in the treatment of PTSD. We aimed to assess the effectiveness and general safety of quetiapine on PTSD. A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and Cochrane guidelines, selecting studies that evaluated the efficacy of quetiapine on global or specific PTSD symptomatology. Ten studies (n = 894) were considered eligible for qualitative synthesis: one case report, one case series, one prospective cohort study, 3 open-label trials, 3 retrospective studies, one randomized controlled trial. Quetiapine was effective on global PTSD symptomatology assessed in 6 studies as well as on re-experiencing (4/4 studies), avoidance (4/3 studies) and hyperarousal (4/4 studies), flashbacks (2/2 studies), depressive (4/4 studies), anxiety (1/1 studies), psychotic (3/3 studies), insomnia (4/5 studies), nightmares (3/3 studies) specific symptoms and PTSD domains. Sedation was among the most frequently observed adverse effects and the main cause of drug discontinuation. Preliminary findings support the efficacy of quetiapine in ameliorating symptoms relative to PTSD and its overall safety. However, quetiapine use in PTSD cannot be recommended yet as studies mainly rely on open-label, retrospective studies or case series.

Abstract

Paroxetine and Sertraline are the only medications approved in posttraumatic stress disorder (PTSD). However, about 60% of traumatized patients fail to show an adequate clinical response. Second generation antipsychotics are recommended as second-line monotherapy or third-line augmentation strategies and quetiapine appears as one of the most used and promising agents. Up to date, no reviews assessed the efficacy of quetiapine in the treatment of PTSD. We aimed to assess the effectiveness and general safety of quetiapine on PTSD. A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and Cochrane guidelines, selecting studies that evaluated the efficacy of quetiapine on global or specific PTSD symptomatology. Ten studies (n = 894) were considered eligible for qualitative synthesis: one case report, one case series, one prospective cohort study, 3 open-label trials, 3 retrospective studies, one randomized controlled trial. Quetiapine was effective on global PTSD symptomatology assessed in 6 studies as well as on re-experiencing (4/4 studies), avoidance (4/3 studies) and hyperarousal (4/4 studies), flashbacks (2/2 studies), depressive (4/4 studies), anxiety (1/1 studies), psychotic (3/3 studies), insomnia (4/5 studies), nightmares (3/3 studies) specific symptoms and PTSD domains. Sedation was among the most frequently observed adverse effects and the main cause of drug discontinuation. Preliminary findings support the efficacy of quetiapine in ameliorating symptoms relative to PTSD and its overall safety. However, quetiapine use in PTSD cannot be recommended yet as studies mainly rely on open-label, retrospective studies or case series.

참고문헌 (47)

  1. Hyun Seo Lee, "Association between Dissociative Symptoms and Morning Cortisol Levels in Patients with Post-traumatic Stress Disorder", Clinical Psychopharmacology and Neuroscience, 20(2), pp.292~299 (2022), 대한정신약물학회[DOI]
  2. 서호준, "A Comparison of Mirtazapine and Paroxetine for the Treatment of Patients with Posttraumatic Stress Disorder: A Randomized Open-label Trial", Clinical Psychopharmacology and Neuroscience, 8(2), pp.84~89 (2010), 대한정신약물학회
  3. Martin A, "Treatment guidelines for PTSD : a systematic review", J Clin Med, 10, pp.4175~ (2021)
  4. Berger W, "Pharmacologic alternatives to antidepressants in posttraumatic stress disorder : a systematic review", Prog Neuropsychopharmacol Biol Psychiatry, 33, pp.169~180 (2009)
  5. Hamner MB, "Treatment-resistant posttraumatic stress disorder : strategies for intervention", CNS Spectr, 9, pp.740~752 (2004)
  6. Ehret M, "Treatment of posttraumatic stress disorder : focus on pharmacotherapy", Ment Health Clin, 9, pp.373~382 (2019)
  7. Bernardy NC, "Prescribing trends in veterans with posttraumatic stress disorder", J Clin Psychiatry, 73, pp.297~303 (2012)
  8. Bauer MS, "Off-label use of second generation antipsychotics for post-traumatic stress disorder in the Department of Veterans Affairs : time trends and sociodemographic, comorbidity, and regional correlates", Pharmacoepidemiol Drug Saf, 23, pp.77~86 (2014)
  9. Holder N, "Trends in medication prescribing in patients with PTSD from 2009 to 2018 : a national veterans administration study", J Clin Psychiatry, 82, pp.20~ (2021)
  10. Delapaz NR, "An emulation of randomized trials of administrating antipsychotics in PTSD patients for outcomes of suicide-related events", J Pers Med, 11, pp.178~ (2021)
  11. Reinhard MA, "Pharmacotherapy of 1, 044 inpatients with posttraumatic stress disorder : current status and trends in German-speaking countries", Eur Arch Psychiatry Clin Neurosci, 271, pp.1065~1076 (2021)
  12. Methley AM, "PICO, PICOS and SPIDER : a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews", BMC Health Serv Res, 14, pp.579~ (2014)
  13. Shea BJ, "AMSTAR 2 : a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both", BMJ, 358, pp.j4008~ (2017)
  14. Page MJ, "The PRISMA 2020 statement : an updated guideline for reporting systematic reviews", BMJ, 372, pp.n71~ (2021)
  15. Sattar SP, "Quetiapine therapy for posttraumatic stress disorder", Ann Pharmacother, 36, pp.1875~1878 (2002)
  16. Filteau MJ, "Quetiapine reduces flashbacks in chronic posttraumatic stress disorder", Can J Psychiatry, 48, pp.282~283 (2003)
  17. Hamner MB, "Quetiapine treatment in patients with posttraumatic stress disorder : an open trial of adjunctive therapy", J Clin Psychopharmacol, 23, pp.15~20 (2003)
  18. Ahearn EP, "Quetiapine as an adjunctive treatment for post-traumatic stress disorder : an 8-week open-label study", Int Clin Psychopharmacol, 21, pp.29~33 (2006)
  19. Byers MG, "Prazosin versus quetiapine for nighttime posttraumatic stress disorder symptoms in veterans : an assessment of long-term comparative effectiveness and safety", J Clin Psychopharmacol, 30, pp.225~229 (2010)
  20. Detweiler MB, "Treatment of post-traumatic stress disorder nightmares at a veterans affairs medical center", J Clin Med, 5, pp.117~ (2016)
  21. Pivac N, "Pharmacotherapy of treatment-resistant combat-related posttraumatic stress disorder with psychotic features", Croat Med J, 47, pp.440~451 (2006)
  22. Sokolski KN, "Quetiapine for treatment of refractory symptoms of combat-related post-traumatic stress disorder", Mil Med, 168, pp.486~489 (2003)
  23. Villarreal G, "Efficacy of quetiapine monotherapy in posttraumatic stress disorder : a randomized, placebo-controlled trial", Am J Psychiatry, 173, pp.1205~1212 (2016)
  24. Baig MR, "Enhancing completion of cognitive processing therapy for posttraumatic stress disorder with quetiapine in veterans with mild traumatic brain injury : a case series", Psychiatr Q, 90, pp.431~445 (2019)
  25. Kozaric-Kovacic D, "Quetiapine treatment in an open trial in combat-related post-traumatic stress disorder with psychotic features", Int J Neuropsychopharmacol, 10, pp.253~261 (2007)
  26. Brinker M, "Severity of combat-related posttraumatic stress disorder versus noncombatrelated posttraumatic stress disorder : a community-based study in American Indian and Hispanic veterans", J Nerv Ment Dis, 195, pp.655~661 (2007)
  27. Campbell-Sills L, "Dissecting the heterogeneity of posttraumatic stress disorder : differences in polygenic risk, stress exposures, and course of PTSD subtypes", Psychol Med (2021)[DOI]
  28. Compean E, "Posttraumatic stress disorder with secondary psychotic features(PTSD-SP) : diagnostic and treatment challenges", Prog Neuropsychopharmacol Biol Psychiatry, 88, pp.265~275 (2019)
  29. Hansen M, "Evidence of the dissociative PTSD subtype : a systematic literature review of latent class and profile analytic studies of PTSD", J Affect Disord, 213, pp.59~69 (2017)
  30. Lanius RA, "Emotion modulation in PTSD : clinical and neurobiological evidence for a dissociative subtype", Am J Psychiatry, 167, pp.640~647 (2010)
  31. Shevlin M, "Evidence for a psychotic posttraumatic stress disorder subtype based on the National Comorbidity Survey", Soc Psychiatry Psychiatr Epidemiol, 46, pp.1069~1078 (2011)
  32. Ipser JC, "Evidence-based pharmacotherapy of posttraumatic stress disorder(PTSD)", Int J Neuropsychopharmacol, 15, pp.825~840 (2012)
  33. de Moraes Costa G, "Pharmacological treatments for adults with post-traumatic stress disorder : a network meta-analysis of comparative efficacy and acceptability", J Psychiatr Res, 130, pp.412~420 (2020)
  34. Hoskins MD, "Pharmacological-assisted psychotherapy for post-traumatic stress disorder : a systematic review and meta-analysis", Eur J Psychotraumatol, 12, pp.1853379~ (2021)
  35. Villarreal G, "Characterizing the effects of quetiapine in military post-traumatic stress disorder", Psychopharmacol Bull, 48, pp.8~17 (2018)
  36. López-Muñoz F, "Active metabolites as antidepressant drugs : the role of norquetiapine in the mechanism of action of quetiapine in the treatment of mood disorders", Front Psychiatry, 4, pp.102~ (2013)
  37. Crapanzano C, "Quetiapine in the anxiety dimension of mood disorders : a systematic review of the literature to support clinical practice", J Clin Psychopharmacol, 41, pp.436~449 (2021)
  38. Crapanzano C, "Olanzapine for the treatment of somatic symptom disorder : biobehavioral processes and clinical implications", Psychosom Med, 84, pp.393~395 (2022)
  39. Cohrs S, "Sleep-promoting properties of quetiapine in healthy subjects", Psychopharmacology(Berl), 174, pp.421~429 (2004)
  40. Raskind MA, "A trial of prazosin for combat trauma PTSD with nightmares in active-duty soldiers returned from Iraq and Afghanistan", Am J Psychiatry, 170, pp.1003~1010 (2013)
  41. Calogero Crapanzano, "Efficacy of Olanzapine in Anxiety Dimension of Schizophrenia: A Systematic Review of Randomized Controlled Trials", Clinical Psychopharmacology and Neuroscience, 20(4), pp.592~599 (2022), 대한정신약물학회[DOI]
  42. Crapanzano C, "Clothiapine : highlights of the pharmacological and clinical profile of an undervalued drug", Swiss Arch Neurol Psychiatr Psychother, 173, pp.w10065~ (2022)
  43. Sema Ketenci, "The Neurochemical Effects of Prazosin Treatment on Fear Circuitry in a Rat Traumatic Stress Model", Clinical Psychopharmacology and Neuroscience, 18(2), pp.219~230 (2020), 대한정신약물학회[DOI]
  44. Giovanna G, "Intranasal oxytocin as a potential therapeutic strategy in post-traumatic stress disorder : a systematic review", Psychoneuroendocrinology, 115, pp.104605~ (2020)
  45. Francesca De Cagna, "The Role of Intranasal Oxytocin in Anxiety and Depressive Disorders: A Systematic Review of Randomized Controlled Trials", Clinical Psychopharmacology and Neuroscience, 17(1), pp.1~11 (2019), 대한정신약물학회[DOI]
  46. Britnell SR, "Aripiprazole for post-traumatic stress disorder : a systematic review", Clin Neuropharmacol, 40, pp.273~278 (2017)
  47. Crapanzano C, "Combining aripiprazole and haloperidol : Focus on D2 Receptor", J Clin Pharmacol, 62, pp.918~ (2022)

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