Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T05:39:59.508Z Has data issue: false hasContentIssue false
  • English
  • Français

Quetiapine in relapsing schizophrenia: clinical efficacy and effect on monoaminergic parameters

Published online by Cambridge University Press:  24 June 2014

F. M. M. A. van der Heijden ,
W. M. A. Verhoeven ,
D. Fekkes ,
A. E. S. Sijben  and
S. Tuinier
F. M. M. A. van der Heijden*
Affiliation:
Vincent van Gogh Institute for Psychiatry, Venray
W. M. A. Verhoeven
Affiliation:
Vincent van Gogh Institute for Psychiatry, Venray Erasmus University Medical Center, Department of Psychiatry, Rotterdam, the Netherlands
D. Fekkes
Affiliation:
Erasmus University Medical Center, Department of Psychiatry, Rotterdam, the Netherlands
A. E. S. Sijben
Affiliation:
Vincent van Gogh Institute for Psychiatry, Venray
S. Tuinier
Affiliation:
Vincent van Gogh Institute for Psychiatry, Venray
*
Vincent van Gogh Institute for Psychiatry, Stationsweg 46, 5803 AC Venray, the Netherlands. Tel. 31 478527339; Fax: 31 478527110; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Methods:

Tolerability, safety and effectiveness of quetiapine in an in-patient group with a relapse of schizophrenia and the possible role of plasma amino acid concentrations, 5-HT parameters and HVA in the prediction of response to treatment were investigated in an open-label baseline-controlled trial of 14 weeks in 21 hospitalized schizophrenic patients. Responders were defined as those patients who exhibit at least a 40% reduction of BPRS total scores. Secondary efficacy measures were the PANSS, the Clinical Global Impression (CGI)-severity scale and the MADRS. Extrapyramidal side-effects were evaluated with the AIMS. Other side-effects were monitored at regular intervals. Amino acids and the derived tryptophan and tyrosine ratios, as well as monoaminergic parameters, were assessed in plasma at baseline and at weeks 3, 6 and 14.

Results:

Treatment with quetiapine resulted in the predefined treatment effect in 10 out of the 17 patients who completed at least 4 weeks of treatment. Effect in responders was observed on all efficacy parameters, including lower MADRS scores. No extrapyramidal side-effects emerged. Clinical and biochemical parameters did not predict response to treatment.

Conclusions:

This study demonstrates the moderate antipsychotic efficacy of quetiapine on preferentially positive symptoms in a group of relatively young schizophrenics. Some observed changes in biochemical parameters are discussed.

Keywords

amino acidsmonoaminesquetiapineschizophrenia
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 15 , Issue 3 , June 2003 , pp. 133 - 139
Copyright
Copyright © 2003 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baldessarini, RJ, Frankenburg, FR. Clozapine. A novel antipsychotic agent. N Engl J Med 1991; 324: 746–754.Google Scholar
Verhoeven, WMA, Doesburg, WH, Snoej, R, Rutgers, AJMP, Van Dongen, PHM. Efficacy of clozapine in treatment-resistant psychosis and neuroleptic sensitivity;results of the Dutch open multi-center project. Eur Psychiatry 1992;7: 77–84. Google Scholar
Arnt, J, Skarsfeldt, T. Do novel antipsychotics have similar pharmacological characteristics? A review of the evidence. Neuropsychopharmacol 1998;18: 63–101. CrossRefGoogle Scholar
Goldstein, JM, Arvanitis, LA. ICI 204,636 (Seroquel): a dibenzothiazepine atypical antipsychotic. Review of preclinical pharmacology and highlights of phase II clinical trials. CNS Drug Rev 1995;1: 50–73. CrossRefGoogle Scholar
Gunasekara, NS, Spencer, CM. Quetiapine, a review of its use in schizophrenia. CNS Drugs 1998;9: 325–340. CrossRefGoogle Scholar
Goldstein, JM. Quetiapine fumarate (Seroquel): a new atypical antipsychotic. Drugs Today 1999;35: 193–210. CrossRefGoogle Scholar
Fabre, LF, Arvanitis, L, Pultz, J, Jones, VM, Malick, JB, Slotnick, VB. ICI 204–636, a novel, atypical antipsychotic. early indication of safety and efficacy in patients with chronic and subchronic schizophrenia. Clin Ther 1995;17: 366–378.CrossRefGoogle Scholar
Borison, RL, Arvanitis, LA, Miller, BG. ICI 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.CrossRefGoogle Scholar
Small, JG, Hirsch, SR, Arvanitis, LA, Miller, BG, Link, CG. Quetiapine in patients with schizophrenia. A high-and low-dose double-blind comparison with placebo. Arch General Psychiatry 1997;54: 549–557. CrossRefGoogle Scholar
Meats, PH. Quetiapine (Seroquel);an effective and well-tolerated atypical antipsychotic. Int J Psychiatry Clin Pract 1997;1: 231–239. CrossRefGoogle Scholar
Arvanitis, LA, Miller, BG. 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.CrossRefGoogle Scholar
Copolov, DL, Link, CG G, Kowalcyk, B. A multicenter, double-blind, randomized comparison of quetiapine (ICI 204–636, ‘Seroquel’) and haloperidol in schizophrenia. Psychol Med 2000;30: 95–105.CrossRefGoogle Scholar
Kasper, S, Tauscher, J, Heiden, A. Quetiapine: efficacy and tolerability in schizophrenia. Eur Neuropsychopharmacol 2001;11: S405–413.CrossRefGoogle Scholar
Sharmat, T. Quetiapine, efficacy in different domains. Eur Neuropsychopharmacol 2001;11: S385–390.CrossRefGoogle Scholar
Peuskens, J, Link, CG G. A comparison of quetiapine and chlorpromazine in the treatment of schizophrenia. Acta Psychiatr Scand 1997;96: 265–273.CrossRefGoogle Scholar
McManus, DQ, Arvanitis, LA, Kowalcyk, BB. Quetiapine, a novel antipsychotic: experience in elderly patients with psychotic disorders. J Clin Psychiatry 1999;60: 292–298.CrossRefGoogle Scholar
McConville, BJ, Arvanitis, LA, Thyrum, PT, Yeh, C, Wilkinson, LA, Chaney, RO, Foster, KD, Sorter, MT, Friedman, LM, Brown, KL, Heubi, JE. Pharmacokinetics, tolerability, and clinical effectiveness of quetiapine fumarate: an open label trial in adolescents with psychotic disorders. J Clin Psychiatry 2000;61: 252–260.CrossRefGoogle Scholar
Taylor, DM, McAskill, R. Atypical antipsychotics and weight gain, a systematic review. Acta Psychiatr Scand 2000;101: 416–432.CrossRefGoogle Scholar
Meyer, JM. Novel antipsychotics and severe hyperlipidemia. J Clin Psychopharmacol 2001;21: 369–374.CrossRefGoogle Scholar
Fernandez, HH, Friedman, JH, Jacques, C, Rosenfeld, M. Quetiapine for the treatment of drug-induced psychosis in Parkinson's disease. Mov Disord 1999;14: 484–487.3.0.CO;2-B>CrossRefGoogle Scholar
Targum, SD, Abbott, JL. Efficacy of quetiapine in Parkinson's patients with psychosis. J Clin Psychopharmacol 2000;20: 54–60.CrossRefGoogle Scholar
Brandstädter, D, Oertel, WH. Treatment of drug-induced psychosis with quetiapine and clozapine in Parkinson's disease. Neurology 2002;58: 160–161.CrossRefGoogle Scholar
Verhoeven, WMA, Rijn-Van Den Meijdenberg, JCC, Hofma, E, Tuinier, S, Fekkes, D, Pepplinkhuizen, L. Aminoacids, norharman and serotonergic parameters in schizophrenia; clinical and biochemical effects of treatment with risperidone. New Trends Exp Clin Psychiatry 1997;13: 117–126. Google Scholar
Mooren, R, Verhoeven, WMA, Tuinier, S, Van Den Berg, YW MM, Fekkes, D, Pepplinkhuizen, L. Olanzapine in schizophrenia;effects on psychotic symptomatology and serotonergic parameters. Eur J Psychiatry 2001;15: 91–100. Google Scholar
Doorakkers, MCHVerhoeven, WMA, Tuinier, S, Van Den Berg, YWMM, Fekkes, D, Pepplinkhuizen, L. Psychopathology, serotonergic parameters and sertindole. Results of a preliminary study in schizophrenia. New Trends Exp Clin Psychiatry 2000;17: 25–30. Google Scholar
Fekkes, D, Van Dalen, A, Edelman, M, Voskuilen, A. Validation of the determination of amino acids in plasma by high-performance liquid chromatography using automated derivatization with o-phtaldialdehyde. J Chromatogr B Biomed Appli 1995;669: 177–186. CrossRefGoogle Scholar
Meltzer, HJ, Maes, M, Lee, MA. The cimetidine-induced increase in prolactin secretion in schizophrenia: effect of clozapine. Psychopharmacology (Berl) 1993;112(Suppl. 1):95–104. CrossRefGoogle ScholarPubMed
Sumiyoshi, T, Hasegawa, M, Jayathilake, K, Meltzer, HY. Prediction of short-term changes in symptom severity by baseline plasma homovanillic acid levels in schizophrenic patients receiving clozapine. Psychiatry Res 1997;69: 113–121.CrossRefGoogle Scholar
Koreen, AR, Lieberman, J, Alvir, J, Mayerhoff, D, Loebel, A, Chakos, M, Amin, F, Cooper, T. Plasma homovanillic acid levels in first-episode schizophrenia. Arch General Psychiatry 1994;51: 132–138. CrossRefGoogle Scholar
Garver, DL, Holcomb, JA, Christensen, JD. Heterogeneity of response to antipsychotics from multiple disorders in the schizophrenia spectrum. J Clin Psychiatry 2000;61: 964–972.CrossRefGoogle ScholarPubMed
Fekkes, D, Pepplinkhuizen, L, Verheij, R, Bruinvels, J. Abnormal plasma levels of serine, methionine, and taurine in transient polymorphic psychosis. Psychiatry Res 1994;51: 11–18.CrossRefGoogle Scholar
Fekkes, D, Pepplinkhuizen, L. Amino acid studies in transient acute polymorphic psychosis. Amino Acids 1997;12: 107–117. CrossRefGoogle Scholar
Van Der Heijden, FMMA, Tuinier, S, Pepplinkhuizen, L, Van Praag, HM, Verhoeven, WMA. Beyond the mainstream: the heuristic value of the cycloid psychosis. Eur J Psychiatry 2002;16: 15–26. Google Scholar
Flyckt, L, Venizelos, N, Edman, G, Bjerkenstedt, L. HagenfeldtL, Wiesel FA. Aberrant tyrosine transport across the cell membrane in patients with schizophrenia. Arch General Psychiatry 2001;58: 953–958. CrossRefGoogle Scholar
Middleton, FA, Mirnics, K, Pierri, JN, Lewis, DA, Levitt, P. Gene expression profiling reveals alterations of specific metabolic pathways in schizophrenia. J Neurosci 2002;22: 2718–2729.Google Scholar
Tortorella, A, Monteleone, P, Fabrazzo, M, Viggiano, A, De Luca, L, Maj, M. Plasma concentrations of amino acids in chronic schizophrenics treated with clozapine. Neuropsychobiol 2001;44: 167–171. CrossRefGoogle Scholar
Wieselgren, IM, Lindstrom, LH. CSF levels of HVA and 5-HIAA in drug-free schizophrenic patients and healthy controls: a prospective study focused on their predictive value for outcome in schizophrenia. Psychiatry Res 1998;81: 101–110.CrossRefGoogle Scholar
Carl, GF, Brogan, MP, Young, BK. Is plasma serine a marker for psychosis? Biol Psychiatry 1991;31: 1130–1135. CrossRefGoogle Scholar
Rao, ML, Gross, G, Strebel, B, Braunig, P, Huber, G, Klosterkotter, J. Serum amino acids, central monoamines, and hormones in drug-naïve, drug-free, and neuroleptic-treated schizophrenic patients and healthy subjects. Psychiatry Res 1990;34: 243–257.CrossRefGoogle Scholar