Quetiapine in schizophrenia: onset of action within the first week of treatment.
OBJECTIVE
Three placebo-controlled clinical trials have established the efficacy of the atypical antipsychotic quetiapine (Seroquel) in schizophrenia. These trials were designed and powered to detect a treatment difference in the primary endpoint at Week 6. The objective of the current analysis was to investigate the effect of quetiapine at earlier timepoints.


METHODS
A combined analysis of data from three acute, double-blind, placebo-controlled, randomised trials was carried out. The trials comprised hospitalised patients with an acute exacerbation of chronic or subchronic schizophrenia who were randomised to receive quetiapine 150-750 mg/day (n = 422) or placebo (n = 198). Symptoms were assessed using changes from baseline to Week 1 in the Brief Psychiatric Rating Scale (BPRS) total score, BPRS positive symptom cluster score and the individual BPRS items of excitement, tension and depression. Changes from baseline to Weeks 1-6 were calculated for BPRS Factor 1 scores (which measures mood symptoms) and Scale for Assessment of Negative Symptoms (SANS) summary scores.


RESULTS
Within 1 week, overall symptom improvement (BPRS total score) was significantly (p < 0.05) greater with quetiapine than with placebo; improvement also occurred in individual BPRS items of excitement, tension and depression. Improvement in negative symptoms was significantly (p < 0.05) greater with quetiapine than with placebo from Week 1, as was the BPRS Factor I score from Week 2. More quetiapine- than placebo-treated patients showed a response of positive symptoms to treatment within 1 week (p < 0.05).


CONCLUSIONS
The beneficial effects of quetiapine are observed within 1 week across a broad spectrum of symptoms.
Small
Joyce G
JG
Indiana University School of Medicine, Larue D. Carter Memorial Hospital, Indianapolis, 46222, USA. gsmall@iupui.edu
Kolar
Madeleine C
MC
Kellams
Jeffrey J
JJ
D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D003987:Dibenzothiazepines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D004311:Double-Blind Method; D006801:Humans; D010919:Placebos; D000069348:Quetiapine Fumarate; D012559:Schizophrenia / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010919:Placebos; D000069348:Quetiapine Fumarate