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.
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
Massimo
M
Pasquini
Azzurra
A
Speca
Massimo
M
Biondi
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