A retrospective analysis of quetiapine in the treatment of pervasive developmental disorders.
BACKGROUND
The purpose of this study was to examine the effectiveness and tolerability of quetiapine for aggression, hyperactivity, and self-injury in pervasive developmental disorders (PDDs).


METHODS
The medical records of all patients with PDDs diagnosed according to DSM-IV criteria and treated with quetiapine were retrospectively reviewed. Patients who received quetiapine for at least 4 weeks and who were not concurrently treated with another antipsychotic or mood stabilizer were included. Improvement was measured with the Clinical Global Impressions-Improvement scale (CGI-I), with response determined by ratings of "much improved" or "very much improved." Data were collected from May 15, 2003 through November 30, 2003.


RESULTS
Of 857 records reviewed, 20 patients (16 male, 4 female) (mean +/- SD age = 12.1 +/- 6.7 years; range, 5-28 years) received a quetiapine trial (mean +/- SD dosage = 248.7 +/- 198.4 mg/day; range, 25-600 mg/day) over a mean duration of 59.8 +/- 55.1 weeks (range, 4-180 weeks). Eight (40%) of 20 patients were judged "responders" to quetiapine; the mean CGI-I score for the entire group was 3.0 +/- 1.1 (minimally improved). A statistically significant improvement (p = .002) was found between a mean pretrial CGI-Severity of Illness scale (CGI-S) score of 5.1 +/- 0.6 (markedly ill) and a posttrial CGI-S score of 4.2 +/- 1.1 (moderately ill). Adverse effects occurred in 50% (N = 10) of patients and led to drug discontinuation in 15% (N = 3) of patients.


CONCLUSIONS
Quetiapine was modestly effective for maladaptive behavior in patients with a PDD. Controlled studies are needed to further assess these preliminary findings.
Corson
Adam H
AH
Department of Psychiatry, Indiana University School of Medicine and Christian Sarkine Autism Treatment Center, James Whitcomb Riley Hospital for Children, Indianapolis, Ind. 46202-4800, USA.
Barkenbus
John E
JE
Posey
David J
DJ
Stigler
Kimberly A
KA
McDougle
Christopher J
CJ
D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000187:drug effects; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000188:drug therapy* / Q000523:psychology; D002675:Child, Preschool; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D004409:Dyskinesia, Drug-Induced / Q000209:etiology; D006801:Humans; D006948:Hyperkinesis / Q000188:drug therapy; D008297:Male; D011569:Psychiatric Status Rating Scales; D000069348:Quetiapine Fumarate; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000188:drug therapy; D012720:Severity of Illness Index; D012890:Sleep / Q000187:drug effects; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate