Concerns about quetiapine

Brett, Jonathan

doi:10.18773/austprescr.2015.032

Cited by 43 publications

(39 citation statements)

References 25 publications

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“…Кветиапин является широко используемым при шизофрении атипичным антипсихотиком во всем мире, благодаря высокой собственно антипсихотической ýффективности, выраженному седативному ýффекту, отсутствию потенцирования повышения концентрации пролактина в крови [18]. Рисперидон наряду с высокой антипсихотической активностью известен в отношении быстрого потенцирования гиперпролактинемии [19].…”

Section: Introductionunclassified

Morphophenotypic predictor of the development of visceral obesity in patients with schizophrenia receiving antipsychotic therapy

et al. 2018

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Objective:revealing the role of morphophenotypic indices in the development of visceral obesity in patients with schizophrenia receiving quetiapine and risperidone therapy.Materials and methods.56 indoor patients with schizophrenia who received quetiapine (n= 23) or risperidone (n= 33) at medium doses were examined. Included persons were from 18 to 65 years old with at least a 1 year history of disease, the condition of which met the criteria of schizophrenia according to ICD-10. The Basis map of sociodemographic and clinical-dynamic signs for patients with schizophrenia was filled in, PANSS in the adapted Russian version – SCI-PANSS, noninvasive bioimpedancemetry, measurement of growth, transversethoracic, biacromial and bicrystal diameter, with calculation of body mass indexes, Tanner and Rees – Eysenk and definition of integral morphophenotypic indicators were carried out. Statistical processing was performed using Student’s t-test with a preliminary estimate of Pearson’s χ2 normal distribution, the Mann – Whitney U test to compare independent samples, the Spearman correlation analysis, the two-sided Fisher test.Results.There were no significant differences in both subgroups in terms of bioimpedancemetry. The correlation between the level of visceral fat and the Rees – Eysenk index in patients receiving risperidone was a moderate inverse: the greater the value of the Rees – Eysenk index, the lower the level of visceral fat (r= –0.73381,t= –4.70833,p= 0.00015). The correlation between the Tanner index and the level of visceral fat in the quetiapine subgroup was strong: the larger the Tanner index, the higher the visceral fat level (r= 0.7763,t= 4.08481,p= 0.00181); in the risperidone subgroup, there was an average direct correlation (r= 0.48133,t= 2.39356,p= 0.02716).Conclusion.The magnitude of the Rees – Eysenk index of schizophrenic patients can be considered among other factors in the management of risperidone in individuals with asthenic physique. The determination of the Tanner index at the beginning of treatment can play the role of a prognostic factor in the development of visceral obesity in patients with schizophrenia in the planned use as a basic therapy for quetiapine.

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Section: Introductionunclassified

Morphophenotypic predictor of the development of visceral obesity in patients with schizophrenia receiving antipsychotic therapy

et al. 2018

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“…1 Quetiapine appeared to fill the niche previously occupied by benzodiazepines. 30 Yet our participants' knowledge of the mechanism of action of quetiapine and safety concerns was limited, despite recent educational campaigns. 14,16 Family physicians mitigated this gap through the use of low dosages and, in keeping with previous literature on guideline use, 31,32 prioritized real-world experience by colleagues -both peers and specialists -over information.…”

Section: Discussionmentioning

confidence: 98%

The lesser of two evils: a qualitative study of quetiapine prescribing by family physicians

Kelly

Dornan

Pringsheim

2018

cmajo

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Global antipsychotic sales in 2010 were US$25.4 billion; of these, Seroquel (quetiapine) was the fifth highest selling pharmaceutical worldwide, costing an estimated US$6.8 billion. 4 In Canada, prescriptions for quetiapine rose by 300% between 2005 and 2012. Using the IMS Brogan Canadian CompuScript databases to identify prescribing data, researchers found that 50% of filled antipsychotic prescriptions in Canada were for quetiapine, and most came from family physicians.2 Although quetiapine is licensed for the treatment of schizophrenia and bipolar disorder and as an adjunctive to antidepressants in moderate to severe depression, much prescribing of quetiapine is offlabel.2,5 Off-label prescribing of antipsychotics has been studied extensively, including a meta-analysis of 170 studies. 6Leslie and colleagues 7 examined prescribing data from the US Department of Veteran Affairs and found that 60.2% of the 279 778 patients who received a prescription for an antipsychotic in 2007 had no indication for its licensed use; of these, 43% were prescribed quetiapine. More recently, researchers in the United Kingdom examined prescribing data using The Health Improvement Network, a primary care database of almost 10 million patients. 5 They found that only 36% (n = 4824) of those prescribed quetiapine had a serious mental illness recorded. Insomnia, anxiety and behavioural disturbance in elderly people and children are common reasons for off-label use. 3,6,8 Evidence of benefit for these indications is disputed. 6,9,10 Adverse metabolic, neurologic and cardiovascular effects 9,11 pose a significant risk of harm.11,12 Maglione and colleagues 6 calculated a number needed to harm of 8 (odds ratio 5.16, 95% confidence interval 2.93-9.51) for neurologic adverse effects in patients with dementia and of 16 (odds ratio 2.72, 95% confidence interval 2.07-3.56) for weight gain and increased appetite in other conditions. Background: Quetiapine is an antipsychotic that is widely prescribed off-label by family physicians despite evidence that safer alternatives exist. The aim of this research was to explore, in-depth, family physicians' reasons for this behaviour.

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“…Following the policy change, we observed a sustained increase in the rate of 25-mg quetiapine dispensing by 11/month (95% CI: [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] and all other quetiapine strengths combined by 14/month (95% CI: [8][9][10][11][12][13][14][15][16][17][18][19][20]. We did not observe a monthly increase in dispensing rate (ramp) for all antipsychotics minus quetiapine, but there was a step increase of 2162 (95% CI: 773-1371) dispensings that occurred gradually over the study period (Table 2).…”

Section: Dispensingsmentioning

confidence: 99%

“…The recommended daily therapeutic quetiapine dose is between 300 and 800 mg for its main indications . The 25‐mg quetiapine strength is only registered and subsidized for dose titration . However, dispensing of this strength alone has been associated with inappropriate off‐label use for indications where evidence of risk and benefit is not definitive such as insomnia, anxiety, and behavioral and psychological symptoms of dementia .…”

Section: Introductionmentioning

confidence: 99%

“…5 The 25-mg quetiapine strength is only registered and subsidized for dose titration. [6][7][8] However, dispensing of this strength alone has been associated with inappropriate off-label use for indications where evidence of risk and benefit is not definitive 9 such as insomnia, anxiety, and behavioral and psychological symptoms of dementia. 10 Even at this lower quetiapine dose, patients continue to experience a range of adverse effects such as weight gain and metabolic disturbances.…”

Section: Introductionmentioning

confidence: 99%

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The impact of permissive and restrictive pharmaceutical policies on quetiapine dispensing: Evaluating a policy pendulum using interrupted time series analysis

Brett

Schaffer

Dobbins

et al. 2018

Pharmacoepidemiology and Drug

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Concerns about quetiapine

Cited by 43 publications

References 25 publications

Morphophenotypic predictor of the development of visceral obesity in patients with schizophrenia receiving antipsychotic therapy

Morphophenotypic predictor of the development of visceral obesity in patients with schizophrenia receiving antipsychotic therapy

The lesser of two evils: a qualitative study of quetiapine prescribing by family physicians

The impact of permissive and restrictive pharmaceutical policies on quetiapine dispensing: Evaluating a policy pendulum using interrupted time series analysis

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