Table 3: Studies with quetiapine

Author; No. of patients Design; Duration, Intervention Outcomes Results
Brown et al. (2002) [66] n=17 OL, Add-on QUE 12 weeks BD + COD QUE (mean dosage 229.4 mg/d) Psychopathology (HDRS, YMRS, BPRS) Cocaine Craving (CQC) Cocaine use (UTS) Significant improvement in psychiatric symptoms (p< 0.01) and cocaine craving (p=0.05). No significant changes in cocaine use
Weisman (2003) [57] n=1 CR 1 year SCH + AA and COA QUE (400 mg/d) Psychopathology Social functioning Alcohol and cocaine use Reduction of psychopathology and improvement of social functioning. Reduction in alcohol and cocaine use
Brown et al. (2003) [58] n=24 OL, Pros, RCT, switch study 12 weeks PSY (9 with SCH or SAD) + SUD Cocaine (69%), Amphetamine (14%) Non-TAP (n=12), QUE (mean dose 394 mg/d) (n=8/12) or TAP (n=12) Psychopathology (HDRS, BPRS) Cocaine craving (CQC) Cocaine or amphetamines use (self-reported money spent on substance use, UTS) After discontinuing TAP and switching to QUE there was a significant improvement in psychopathology (p< 0.05) and a significant craving reduction (p< 0.01), with no significant differences in the amount of drug use
Longoria et al. (2004) [61] n=17 OL, add-on study 12 weeks BD + COD QUE (mean dosage 239 mg/d) Psychiatric symptoms (YMRS, HDRS, BPRS) Alcohol use (alcohol drinks/week, days/week of alcohol use) Alcohol craving (VAS) QUE was associated with significant reductions in craving (p=0.02), days/week of alcohol use (p=0.04) and psychiatric symptoms (p< 0.01). Depressive symptoms significantly correlated with craving (p=0.029)
Potvin et al. (2004) [65] n=8 OL study 6 months SCH (n=4) or BD (n=4) + CAD QUE (dosage N.S.) Cannabis use Weekly cannabis use was reduced in 97.3% at the end of the study
Potvin et al. (2006) [59] n=34 OL study 12 weeks SSD + SUD Cannabis (n=15), alcohol (n=10), other psychoactive substances (n=9) QUE (200-800 mg/d) Drug Use (TLFB, UTS, GGT) Severity of drug use (AUS, DUS) Carving (VAS, PACS) Psychiatric and depressive symptoms (PANSS, CDSS) Cognition (CANTAB) Overall, severity of SUD improved (p< 0.05), fewer days/week were spent on SUD. Money/week spent on alcohol significantly diminished (p< 0.05), but money/week spent on cannabis did not diminished significantly. Craving for alcohol did not improve significantly, but craving for cannabis significantly diminished (p< 0.05) There were significant improvements in psychopathology (p< 0.01) and cognition (p< 0.05)
Potvin et al. (2008) [60] n=24 Peripheral ECB No significant changes in ECB levels were observed during QUE treatment
Brown et al. (2008) [63] n=115 Pros, R, PC, Add-on study 12 weeks BD outpatients + AA or AD QUE (up to 600 mg/d) or PLA Psychiatric symptoms (YMRS, HDRS) Alcohol use HDRS scores decreased significantly more in the QUE group compared to the PLA group (p< 0.05). No significant differences were found in the decrease of the YMRS scores and in alcohol use
Martinotti et al. (2008) [62] n=28 OL, FD study 16 weeks Recently detoxified BD (n=16) and SAD (n=2) + AD QUE (300-800 mg/d) Relapse rate (number of drinking days) Craving (OCDS, VAS) Psychopathology (BPRS, HDRS, YMRS, CGI) 42.8% of patients remained alcohol free at the end of the study. 32.1% relapsed. Significant reductions from baseline to exit were observed in craving (p< 0.005), psychopathology (p< 0.0001) and number of drinking days/week (p=0.005)
Steadman et al. (2010) [64] n=176 MC, DB, RPCT 12 weeks Outpatient BD + AD Treatment with LIT (n=185) or VAL (n=177) + QUE (300-800 mg/d) (n=159) or PLA (n=169) Change in the proportion of heavy drinking days (TLFB) Psychopathology (CGI, HARS) No significant differences in the proportion of heavy drinking days between QUE and PLA. No significant differences in improvement in psychopathology
Zhornitsky et al. (2011) [67] CC study 12 weeks DD (n=26), SCH without SUD (n=23), SUD without SCH (n=24) QUE (mean dosages in the three groups: 554, 478 and 150 mg/d, respectively) Neurological and psychiatric symptoms (PANSS, ESRS, BAS) Substance use (TLFB, UTS) DD and SCH patients were receiving significantly higher doses of QUE (p=0.0001). DD patients had significantly higher parkinsonism (p=0.02) and depression (p=0.005). DD patients had significantly higher SUD severity compared to SUD patients (p<0.001)

AA: Alcohol Abuse, AD: Alcohol Dependence, AUS: Alcohol Use Scale, BAS: Barnes Akathisia Scale, BD: Bipolar Disorder, BPRS: Brief Psychiatric Rating Scale, CAD: Cannabis Dependence, CANTAB: Cambridge Neuropsychological Test Automated Battery, CC: Case-Control, CDSS: Calgary Depression Scale for Schizophrenia, CGI: Clinical Global Impression, COA: Cocaine Abuse, COD: Cocaine Dependence, CQC: Cocaine Craving Questionnaire, CR: Case Report, DB: Double blinded, DD: Dual Diagnosis, DUS: Drug Use Scale, ECB: Endogenous Cannabinoids, ESRS: Extrapyramidal Symptoms Rating Scale, FD: Flexible dose, GGT: GammaGlutamyltranpeptidase, HARS: Hamilton Anxiety Rating Scale, HDRS: Hamilton Depression Rating Scale, LIT: Lithium, MC: Multicenter, OCDS: Obsessive Compulsive Drinking Scale, OL: Open label, PACS: Penn Alcohol Craving Scale, PANSS: Positive and Negative Symptoms Scale, Pros: Prospective, PSY: Psychotic Disorder, QUE: Quetiapine, PLA: Placebo, RCT: Randomized Controlled Trials, RPCT: Randomized Placebo Controlled Trials, SAD: Schizoaffective Disorder, SCH: Schizophrenia, SSD: Schizophrenic Spectrum Disorders, SUD: Substance Use Disorder, TAP: Typical Antipsychotics, TLFB: Timeline Follow Back, UTS: Urine Toxicological Screens, VAL: Valproate, VAS: Visual Analogue scale, YMRS: Young Mania Rating Scale