Search

Background: The first episode of a psychotic disorder provides a unique opportunity to initiate optimal treatment but when a new medication becomes available, little data exist to guide the appropriate use in this population., Objectives: The objectives were to determine the optimal doses and titration of quetiapine for this group and to measure outcomes (including symptom response, social functioning, mood alterations, motor symptoms, metabolic parameters and cognitive functioning) over 2 years of treatment with quetiapine., Design: Thirty nine subjects with a first episode of psychosis referred to the Nova Scotia Early Psychosis Program in Halifax, Canada, were invited to participate in this study. Standardized clinical, laboratory, and neuropsychological assessments were performed at baseline and following treatment with quetiapine at intervals out to 2 years., Results: Quetiapine was effective in treating the psychotic and mood symptoms while not causing extra-pyramidal signs or symptoms (EPSS). Pre-existing motor dysfunction improved. No anticholinergic medications were required. Several domains of cognitive function also improved (sustained attention, the number of perseverative errors, visuomotor speed and sequencing, verbal fluency and verbal memory). Weight gain was observed along with increases in cholesterol levels but there was no glucose dysregulation., Conclusions: The results of this two year, naturalistic study of people with a first episode of psychosis indicated that quetiapine was well tolerated and effective for this population. Significant improvements in cognitive functioning also provided evidence for potential longer-term benefits of early and optimal treatment with this agent. However, monitoring metabolic parameters, as recommended for other atypicals, is likely prudent.

Background: The efficacies of second-generation antipsychotic medications in reducing symptoms are reasonably well-documented, but their effects on cognition are less clearly understood., Aims: To under take an interim analysis of an open label, 2-year study examining the effects of quetiapine on cognition in patients with a first episode of schizophrenia and related disorders., Method: Cognitive testing was performed before quetiapine was initiated and repeated after 3, 6 and 12 months of treatment. To date, 13 patients have been fully assessed (mean dose 517.9 mg/day; s.d. = 225.8)., Results: Statistically significant improvement was noted on measures of attention (Continuous Performance Test; CPT), verbal productivity (Verbal Fluency Test) and executive function (Object Alternation Test) after 6 and 12 months of treatment. For the CPT, improvement was also noted after 3 months of treatment., Conclusions: During treatment for 1 year with quetiapine, cognitive performance was improved in young patients with psychosis. Continued controlled investigations of the effects of quetiapine on cognition are desirable.

Objective To determine clinical response, dosing and adverse events associated with quetiapine treatment in early psychosis. Method 40 Patients (33 men; 7 women; mean age 23.75) with schizophrenia spectrum disorders and less than 6 months previous exposure to antipsychotic treatment, entered an open label, 2 years, flexible dose trial and were assessed with PANSS, CGI, GAF, SOFAS, ESRS, BMI and ocular exams at baseline and 6 month intervals thereafter. Results Among 30 patients who enrolled >1 years ago, 19 (63%) completed 1-year assessment. Dropouts were due to insufficient clinical response (13%), nonadherence (13%) and personal choice (10%). At 1 year, significant improvement was observed on the PANSS, CGI, GAF and SOFAS. Mean dose was 559 (±207) mg/day. No drug induced EPS was noted and EPS present at baseline was reduced. Mean change in BMI was 17% (±22). No ocular changes were observed. Conclusions Quetiapine was well tolerated. Clinical response was similar to that achieved with other second generation antipsychotic agents in the same early psychosis programme. [ABSTRACT FROM AUTHOR]