Clinical Experience with Quetiapine in Elderly Patients with Psychotic Disorders

Abstract

Quetiapine fumarate is a recently marketed atypical antipsychotic medication proved to be effective in the treatment of schizophrenia and schizoaffective disorder in the younger population. There is a paucity of studies of this drug in the elderly and more data are needed on the effects of quetiapine in this population, especially those with comorbid medical illnesses. Quetiapine was used to treat seven elderly hospitalized patients between 61 and 72 years of age who manifested signs of psychosis related to schizophrenia, schizoaffective disorder, or bipolar disorder. All patients had been treated previously with conventional antipsychotics or other atypical antipsychotics. Response was assessed by observation of patient's behavior. Four patients responded to treatment; three did not respond. Positive symptoms decreased markedly in all four responders. Negative symptoms showed marked decrease in two patients and moderate decrease in one patient. Preexisting extrapyramidal symptoms (EPS) diminished in three patients. Transient hypotension, dizziness, and somnolence occurred in two patients. No other side effects were noted. No adverse consequences occurred when lithium, carbamazepine, valproic acid, or venlafaxine was given concurrently. The reduction of positive and negative symptoms of schizophrenia and lack of significant EPS and minimal sedative, hypotensive, and anticholinergic side effects indicate that quetiapine may be a safe and effective medication for the elderly. (J Geriatr Psychiatry Neurol 2000; 13:28-32).

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References

Physician's desk reference. Montvale, NJ: Medical Economics, 1999.

Goldstein JM , Litwin LC , Sutton EB , et al. Seroquel: electrophysiological profile of a potential atypical antipsychotic . Psychopharmacology (Berl) 1993; 112:293-298.

Arvanitis LA , Miller BG , and the Seroquel Trial 13 Study Group. Multiple fixed doses of seroquel (quetiapine) in patients with acute exacerbation of schizophrenia: a comparison with haloperidol and placebo. Biol Psychiatry 1997; 42:233-246.

Peuskens J , Link CG. A comparison of quetiapine and chloropromazine in the treatment of schizophrenia. Acta Psychiatr Scand 1997; 96:265-273.

McManus DQ , Arvanitis LA , and Kowalcyr BB for the Seroquel Trial 48 Study Group. Quetiapine, a novel antipsychotic: experience in elderly patients with psychotic disorders. J Clin Psychiatry 1999; 60:5:292-298.

Borison R , Arvanitis L , Miller B. Group USSICI 204, 636, an atypical antipsychotic: efficacy and safety in a multicenter, placebo-controlled trial in patients with schizophrenia. J Clin Psychopharmacol 1996; 16:158-169.

Small J , Hirsch S , Arvanitis L , et al. Quetiapine in patients with schizophrenia: a high and low dose double-blind comparison with placebo. Arch Gen Psychiatry 1997; 54:549-557.

Meats P. Quetiapine (Seroquel); an effective and well tolerated atypical antipsychotic. Int J Psychiatr Clin Pract 1997; 1:231-239.

Overall JE , Gorham DR. The Brief Psychiatric Rating Scale. Psychiatr Reports 1962; 10:799-812.

10.

Andreason N. Modified scale for the assessment of negative symptoms. NIMH treatment strategies in schizophrenia study. ADM 9-102, 9/85, Washington, DC: Public Health Administration, U.S. Department of Health and Human Services , 1985.