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Antipsychotic Drugs
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Harleen Kaur, Ramneek Kaur, Varsha Rani, Kanishka Sharma, Pawan Kumar Maurya
Quetiapine is effective for the treatment against positive symptoms of subchronic and chronic symptoms of schizophrenia. As measured by positive and negative syndrome scale (PANSS), this drug has enhanced negative symptoms of schizophrenia (Vardigan et al., 2010). Quetiapine was statistically related to minimize the level of akathisia. According to the study of population, this drug was well tolerated. The major worst events were either moderate or mild like insomnia or agitation (Van den Eynde et al., 2008). As compared to chlorpromazine, quetiapine was related with less clinically vital signs and low postural hypotension. This drug is not related to increase serum prolactin level.
Questions
Published in Neel Sharma, Tiago Villanueva, SBAs and EMQs in Psychiatry for Medical Students, 2019
A 54-year-old gentleman is referred to the mental health department by his GP following concerns in his mental state. He initially presented over four months ago stating that he is hearing voices telling him he is the King of Israel and that he has the ability to control people’s thoughts. He was commenced initially on olanzapine for six weeks, which was then changed to quetiapine following no improvement in his mental state. During the consultation he continues to state he is the King of Israel and that he has been put on this earth to harm people. Which management plan would you instigate first? Continue quetiapine and reviewCommence risperidoneCommence aripiprazoleCommence clozapineCommence citalopram
Psychiatric Treatment Approaches for Pediatric Pain
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Quetiapine is an atypical antipsychotic also approved for schizophrenia and bipolar mania in adolescents, as well as for depression in adults. This benefit, unique among antipsychotics, may come from partial agonism at 5HT1A receptors, particularly at higher dosages. At low doses (commonly used in youth), quetiapine primarily exhibits antihistaminergic properties, contributing to sedation and increases in appetite. Therefore, quetiapine often is used to address sleep problems in patients with severe depression or PTSD to reduce hypervigilance and cognitive perseveration and to normalize sleep architecture. It has shown adjunctive benefit when combined with SSRIs for several indications, including depression, PTSD, and severe anxiety disorders.
Pharmacological Treatment of Generalised Anxiety Disorder: Current Practice and Future Directions
Published in Expert Review of Neurotherapeutics, 2023
Harry A. Fagan, David S. Baldwin
As highlighted above, the second-generation antipsychotic quetiapine demonstrated the highest efficacy in the treatment of GAD [18]. This is based on four RCTs using extended-release dosages of 50–300 mg daily. It was, however, also associated with significant rates of drop out in treatment vs. placebo groups [18]. Quetiapine displays a broad range of receptor antagonism including H1, α1 and α2-adrenocepter, 5-HT2A and 5-HT2C receptors, alongside a comparably low affinity to the D2 dopamine receptor [46]. It is widely used in psychiatric practice, in the treatment of patients with schizophrenia, bipolar disorder, or unipolar depression. Common adverse effects of quetiapine include sedation (secondary to H1 receptor blockade), dizziness (secondary to adrenergic blockade), and weight gain (secondary to H1 and 5-HT2C receptor blockade) [47]. Unlike most other antipsychotics, it is rarely associated with extra-pyramidal side effects or hyperprolactinemia [47]. No other antipsychotic has been considered as a monotherapy in RCTs for GAD, although other antipsychotics (most notably olanzapine) have been investigated as augmentation strategies (see section 2.14).
Atypical antipsychotics in the treatment of patients with a dual diagnosis of schizophrenia spectrum disorders and substance use disorders: the results of a randomized comparative study
Published in Journal of Addictive Diseases, 2021
V. Yu. Skryabin, M. A. Vinnikova, E. V. Ezhkova, M. S. Titkov, R. A. Bulatova
The total study duration was 21 days, which corresponds to the standard course of inpatient treatment. Visit 0 corresponded to days 1–5 of inpatient treatment and included the procedures on screening and establishing the dual diagnosis of mental and behavioral disorders due to multiple drug use (F19) and paranoid schizophrenia (F20), or schizotypal disorder (F21) (Table 1). The substance withdrawal syndrome was treated during 4–5 days using the standard therapy (Hopantenic acid, the amide of D-pantoate and γ-aminobutyric acid (GABA), is a central nervous system depressant which is used as a pharmaceutical drug in the Russian Federation for a variety of neurological, psychological and psychiatric conditions.) (Table 2), which did not differ across groups. On day 5 of inpatient treatment (i.e., after the therapy of substance withdrawal syndrome), randomization (Visit 1) was carried out using a random number generator and the sealed envelope method. Each patient was assigned a two-digit serial number from 01 to 90 if he met the inclusion/exclusion criteria so that all patients with a dual diagnosis were divided into three groups (N = 30) depending on the pharmacological agent. Patients in the first main group were prescribed Aripiprazole (A) in a dose of up to 20 mg daily. Patients of the second main group were prescribed Quetiapine (Q) in a dose of up to 600 mg daily. Patients of the third (control) group were prescribed Haloperidol (H) in a dose of up to 30 mg daily. The main targets of therapy were positive (affective and behavioral disorders) and negative symptoms of the mental disorder.
Hospitalization risk among adults with bipolar I disorder treated with lurasidone versus other oral atypical antipsychotics: a retrospective analysis of Medicaid claims data
Published in Current Medical Research and Opinion, 2021
Xiaoli Niu, Phani Veeranki, Syvart Dennen, Carole Dembek, Kimberly Laubmeier, Yanmei Liu, G. Rhys Williams, Antony Loebel
In our analysis, patients treated with lurasidone had higher rates of antidepressant use in the pre-index period compared to olanzapine, quetiapine and risperidone. Though not directly comparable due to the study design, the rates of antidepressant use were not significantly different between treatment cohorts during the follow-up period (except aripiprazole). This drop in antidepressant use may indicate better control of depressive symptoms in patients treated with lurasidone (Supplementary Materials Table S4). More than half of treatment months for quetiapine were prescribed at a sub-therapeutic level (median 100 mg per day vs. 300–800 mg per day indicated for bipolar disorder) (Supplementary Materials Table S3). Re-analysis of the data excluding patients prescribed sub-therapeutic levels of quetiapine did not change the conclusions of the study. In fact, higher doses of quetiapine were associated with higher risk of hospitalization (not shown). Physicians may have prescribed lower doses of quetiapine to their patients to avoid treatment-emergent side-effects.