Posted by Judy on January 8, 2000, at 17:16:31
In reply to Seroquel for Depression ?, posted by Scott L. Schofield on January 6, 2000, at 10:39:45
Coincidentally, I just read this article on Seroquel at Medscape today before I saw your post. Sounds good. I'll copy it all for those who don't have Medscape passwords.
************************
Seroquel Manages Depressive Symptoms and Minimizes Adverse Effects
December 15, 1999
MedscapeWire
--------------------------------------------------------------------------------Further evidence of the efficacy of the atypical antipsychotic Seroquel (quetiapine fumarate) was presented this week at a major US psychiatric conference. Studies show that Seroquel effectively controls the devastating depressive symptoms of psychosis with few of the adverse effects common with other antipsychotics that often interfere with treatment.
"The data presented support the use of Seroquel as a first-line treatment for psychotic disorders," said Jamie Mullen, MD, medical director of CNS Therapeutic Area at AstraZeneca, the manufacturer of Seroquel. "Patients treated with Seroquel experienced little weight gain and less incidence of tardive dyskinesia (TD), and overall had better control over depressive symptoms. By minimizing side effects and offering effective control over symptoms of psychosis, Seroquel offers doctors and patients an important choice in the battle against mental illness."
A recent study showed that the Seroquel was effective against the depressive symptoms in patients, particularly those who entered the trial with high scores on one of the most widely used instruments for clinical assessment of depressive symptoms, the Hamilton Rating Scale for Depression (HAM-D). Seven hundred fifty-one adult outpatients with psychotic disorders participated in the 4-month, multicenter, open-label safety and tolerability trial which additionally compared the efficacy of Seroquel and risperidone against depressive symptoms. Patients taking Seroquel had improvement in HAM-D scores by 44.6%.
"Although they might not be as obvious to the outside world as hallucinations and delusions, depressive symptoms can be just as devastating for patients suffering from psychosis," said Martha Sajatovic, an author of the study and assistant professor of psychiatry, Case Western Reserve University School of Medicine. "This study demonstrates that quetiapine fumarate offers patients improvement in the symptoms of psychosis and may provide an opportunity to live a more normal life."
Some adverse effects associated with antipsychotics can range from moderately troubling to potentially serious, and all can impact patients' quality of life. Approximately half of the patients recovering from a relapse stop taking medications within 1 year, and doctors say patients sometimes stop taking medication because of troublesome adverse effects such as weight gain, restlessness, and tremors.
One serious side effect of antipsychotic treatment is TD, a disorder that causes potentially irreversible involuntary muscle movements. Almost 1500 patients participating in 3 phase III clinical trials were assessed for TD after receiving Seroquel. Researchers found that the incidence of the disorder was lower than the incidence of TD associated with conventional antipsychotic medications in other studies.
Researchers also investigated the incidence of weight gain in 2216 patients taking Seroquel in controlled, uncontrolled, and open-label extension trials. Data were reported on weight changes observed in this large group with specified time intervals. After 9 months to a year of taking the medication, patients treated with Seroquel gained a mean of only 6 pounds.
"In general, the atypical antipsychotics do a better job of controlling the negative symptoms of psychosis and have much less chance of causing extrapyramidal symptoms (EPS) such as tremors and inability to sit still," said Dr. Mullen. "However, some of these atypical agents are associated with significant weight gain. The data presented here indicate that this problem is not significant for patients taking Seroquel."
Clinical trials with Seroquel have demonstrated efficacy in treating the positive and negative symptoms of schizophrenia. There were no differences from placebo across the clinical dose range in the incidence of EPS, including rigidity and difficulty starting and stopping movement, or elevation of plasma prolactin levels. In addition, studies have shown that Seroquel exhibits a low incidence of hormonal, reproductive (sexual dysfunction), and anticholinergic adverse effects (dry mouth, constipation).
In clinical trials, efficacy was demonstrated in a dose range of 150 mg/day to 750 mg/day. An initial target dose range of 300-400 mg can be given in 2 divided doses daily.
poster:Judy
thread:18201
URL: http://www.dr-bob.org/babble/20000101/msgs/18413.html