Quetiapine for tamoxifen-induced insomnia in women with breast cancer.
BACKGROUND
Insomnia is a frequent adverse effect reported by women taking tamoxifen, an estradiol receptor-antagonist, for breast cancer.


OBJECTIVE
The authors report on six patients treated with quetiapine, an atypical antipsychotic, for tamoxifen-related insomnia without depression.


METHODS
Quetiapine was started at 25 mg/day 1 hour before bedtime; dose adjustments upward were made in 25-mg increments, titrated to a maximum dose of 100 mg according to therapeutic response and tolerance.


RESULTS
Five of the six women showed a prompt improvement of their insomnia; this effect was maintained after 6 weeks of treatment.


CONCLUSIONS
Quetiapine might improve sleep alterations because of its high affinity for serotonergic receptors, enhancing central serotonergic neurotransmission, thus possibly decreasing excitatory glutamatergic transmission.
Pasquini
Massimo
M
Dept. of Psychiatric Science and Psychological Medicine, Psycho-oncology Unit, SAPIENZA, University of Rome, Viale dell'Università 30, 00185, Rome, Italy. massimo.pasquini@uniroma1.it
Speca
Azzurra
A
Biondi
Massimo
M
D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D004965:Estrogen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D000069348:Quetiapine Fumarate; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use
D003987:Dibenzothiazepines; D004965:Estrogen Antagonists; D013629:Tamoxifen; D000069348:Quetiapine Fumarate