title: Quetiapine decreases alcohol consumption, craving, and psychiatric symptoms in dually diagnosed alcoholics.
abstract: OBJECTIVE
  Patients with dual diagnosis are often excluded from clinical trials although more than half of all individuals with Bipolar Disorder have a substance abuse problem at some point in their lifetime, representing a high-risk clinical population. The purpose of this study was to investigate the safety and efficacy of quetiapine in the treatment of alcohol dependence comorbid with disorders characterized by high levels of mood and behavioral instability.
  
  
  METHODS
  Twenty-eight subjects, after a detoxification period, were orally treated with flexible doses of quetiapine for 16 weeks. At each assessment patients were evaluated through the Obsessive Compulsive Drinking Scale (OCDS), the Visual Analogue Scale (VAS) for craving, the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale (HDRS), the Young Mania Rating Scale (YMRS), and the Clinical Global Impression (CGI) scale.
  
  
  RESULTS
  Forty-three percent of patients remained totally alcohol free, 32% patients relapsed, with an average of 15.4 drinking days in the period of the study (112 days) and 25% dropped-out. Significant reductions from baseline to exit were observed in the OCDS, VAS, BPRS, HDRS, and number of drinking days per week. Changes in alcohol craving correlated with psychiatric symptoms as to BPRS and HDRS, with the highest level of correlation evidenced for the HDRS items of insomnia.
  
  
  CONCLUSIONS
  In this open-label study, quetiapine decreased alcohol consumption, craving for alcohol, and psychiatric symptoms intensity, maintaining a good level of tolerance. A strength of this study is that the use of quetiapine was not adjunctive with other pharmacological and non-pharmacological treatment. Double-blind placebo-controlled studies are required with a larger study population to confirm these data. In the meantime, for a select group of psychiatric patients, quetiapine may offer some advantages in preventing relapse.
authors.affiliation: Department of Psychiatry-Addictive Behaviours Unit, Catholic University Medical School, Rome, Italy. giovanni.martinotti@libero.it
authors.forename: G
authors.initials: G
authors.lastname: Martinotti
authors.forename: S
authors.initials: S
authors.lastname: Andreoli
authors.forename: M
authors.initials: M
authors.lastname: Di Nicola
authors.forename: M
authors.initials: M
authors.lastname: Di Giannantonio
authors.forename: M
authors.initials: M
authors.lastname: Sarchiapone
authors.forename: L
authors.initials: L
authors.lastname: Janiri
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control; D000437:Alcoholism / Q000150:complications / Q000534:rehabilitation*; D014150:Antipsychotic Agents / Q000494:pharmacology*; D017831:Diagnosis, Dual (Psychiatry); D003987:Dibenzothiazepines / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy*; D011569:Psychiatric Status Rating Scales; D000069348:Quetiapine Fumarate; D055502:Secondary Prevention
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate