Quetiapine improves response inhibition in alcohol dependent patients: A placebo-controlled pilot study

Abstract

Rationale Quetiapine has been shown to be a promising medication for the treatment of alcoholism. As an atypical antipsychotic medication with antagonist activity at D1 and D2, 5-HT1A and 5-HT2A, H1 and α1 and α2 receptors, quetiapine has been found to decrease impulsivity in other psychiatric disorders but its effects on impulsivity have not been studied in alcohol dependent patients. Objective This study seeks to test the effects of quetiapine on a specific dimension of impulsivity, namely response inhibition. This pilot study seeks to further elucidate the mechanisms of action of quetiapine for alcohol use disorders. Method A total of 20 non-treatment seeking alcohol dependent individuals were randomized to one of the following conditions in a double-blind, placebo-controlled design: (1) quetiapine (400 mg/day); or (2) matched placebo. Participants completed two counterbalanced intravenous placebo-alcohol administration sessions as well as behavioral measure of response inhibition (i.e. stop signal task) pre and post placebo-alcohol administration sessions. Results Analyses revealed a significant effect of quetiapine in improving response inhibition as measured by the stop signal task. These results provide preliminary evidence suggesting that quetiapine improves response inhibition in alcohol dependent patients, as compared to placebo. Conclusion This pilot study contributes a novel putative mechanism of action of quetiapine in alcoholism, namely an improvement in response inhibition.

Multicenter evaluation of pharmacologic management and outcomes associated with severe resistant alcohol withdrawal

“…Given the potential difficulty that occurs between differentiating delirium related to alcohol withdrawal to that of ICU or hospital stay, it is difficult to understand their place in therapy. Atypical antipsychotics have been evaluated in the reduction of alcohol use in alcohol-dependent patients with contrasting results but have not been studied in acute alcohol withdrawal [34][35][36]. Given the potential adverse effects that may occur with antipsychotic use, including neuroleptic malignant syndrome and QTc interval prolongation, and variable efficacy and safety, the low incidence of antipsychotic use in our population may be warranted.…”

Cognitive control in alcohol use disorder: deficits and clinical relevance

“…Atypical antipsychotics (which transiently block D2 receptors) have looked promising in the past, as evidenced by combined work showing that quetiapine improves response inhibition in AUD patients (Moallem and Ray, 2012), and appears to decrease drinking in type B alcoholics (Kampman et al, 2007) in a larger, multisite study. However, typology did not predict response to quetiapine in a second study attempting to replicate the findings from Kampmen et al (Litten et al, 2013), and therefore studies within this drug class may not be highest on the priority list in future mediational studies focused on cognitive control.…”

Quetiapine may reduce hospital admission rates in patients with mental health problems and alcohol addiction

“…The results of this study showed quetiapine improved sleep disturbance and may help in alcohol reduction and maintaining abstinence. Moallem et al 4 adds further evidence with their published pilot study showing that quetiapine improves response inhibition in alcohol dependence. Sattar et al 5 also showed the benefits of quetiapine in the treatment of substance dependence disorders.…”