Long-term efficacy and tolerability of quetiapine in patients with schizophrenia who switched from other antipsychotics because of inadequate therapeutic response—a prospective open-label study

Abstract

BackgroundWhile the frequency and importance of antipsychotic switching in patients with schizophrenia, there is insufficient evidence with regard to switching strategy. Quetiapine is one of the drugs of choice for switch because of its unique receptor profile. However, there were no data on the long-term clinical and neurocognitive effect of quetiapine in patients who had responded inadequately to prior antipsychotics. The purpose of this study is to examine the long-term efficacy and tolerability of quetiapine in patients with schizophrenia who switched from other antipsychotics because of inadequate therapeutic response. We hypothesized that quetiapine would show long-term effectiveness in broad symptom dimensions including negative and neurocognitive symptoms while having good tolerability.MethodsTwenty-nine subjects with schizophrenia who did not respond to their current monotherapy of antipsychotic or who could not tolerate the treatment were switched to quetiapine and assessed at baseline and at 3, 6, and 12 months. The outcome measures included the brief assessment of cognition in schizophrenia (BACS), the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impressions Scale (CGI), the Schizophrenia Quality of Life Scale Japanese version (JSQLS), the Athens Insomnia Scale (AIS), and the Drug Attitude Inventory with 30 items (DAI-30). The Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS), HbA1c, prolactin (PRL), and body weight were also evaluated.ResultsStatistically significant improvements were observed in all subscores of the PANSS, the GAF, and the symptoms and side effects subscale of the JSQLS, the DIEPSS, the AIS, and the PRL level, and nearly significant improvements were observed in the DAI-30. Quetiapine monotherapy was associated with significant improvement in the verbal memory test, even after controlling for the practice effect. Although quetiapine was well tolerated, three subjects dropped out because of the worsening of the psychotic symptoms and two additional subjects dropped out because of somnolence.ConclusionIn this open-label, single-arm study of 29 patients, quetiapine improved both the clinical symptoms and the neurocognitive impairment in chronic schizophrenia patients who failed to respond to prior antipsychotic treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12991-014-0039-6) contains supplementary material, which is available to authorized users.

Long-term health-related quality of life improvements among patients treated with lurasidone: results from the open-label extension of a switch trial in schizophrenia

“…A study by Roussidis and colleagues showed that switching a patient’s antipsychotic medication for reasons related to lack of efficacy and/or tolerability was associated with a significantly improved clinical benefit and increased adherence to treatment [ 74 ]. Similarly, studies of patients switching to olanzapine [ 28 ], quetiapine [ 29 , 34 ], ziprasidone [ 33 , 75 ], aripiprazole [ 76 ], long-acting injectable risperidone [ 32 , 77 ], or paliperidone [ 36 ] have reported improvements in cognitive function, psychotic symptoms, and/or tolerability during up to one year of treatment. However, the current analysis is the only switch study to examine long-term changes in subjective responses, tolerability, adherence-related attitude, and HRQoL using the disease-specific PETiT assessment.…”

Beyond Emotional and Spatial Processes: Cognitive Dysfunction in a Depressive Phenotype Produced by Long Photoperiod Exposure

“…There are cognitive dysfunctions also present in depression, which have been shown to persist even when the affective symptoms are in remission, and worsen with every depressive episode [2,4,5]. This implies two things: one, the cognitive and affective aspects of depression are independent of each other, and two, the neural underpinnings of depression might persist even if affective symptoms aren’t displayed.…”

“…Measures of depression-related cognition have focused, therefore, on spatial processes, because they are hippocampal-dependent [36–40]. However, spatial memory deficits do not fully encompass the cognitive dysfunction seen in depressed patients [2,3,5,29]. Novel object recognition (NOR has been shown to rely on structures distinct from the hippocampus, and is considered a cognitive, not spatial task [41–44].…”

Iron-deficiency anemia with lithobezoar (pica): a rare cause of intestinal obstruction in a 5-year-old Nigerian child

“…This patient had been ingesting stones probably over a long period and showed a rare presentation of acute intestinal obstruction. While such a clinical presentation has been reported in the literature, 23 – 25 none of the patients, to our best knowledge, had ingested such a large amount of stones so as to cover the length of the large bowel (from the colon to the rectum). The findings of hematological indices and iron studies suggestive of IDA were consistent with most of the case reports on pica.…”