title: Management of acutely ill patients in the hospital setting: focus on quetiapine.
abstract: We have considered published work and clinical experience focusing on the atypical antipsychotic quetiapine in order to form a consensus on the most appropriate treatment strategies for hospitalised patients with acute schizophrenia or bipolar disorder. It is important to consider the specific treatment needs of these patients and these are discussed in the context of current treatment guidelines. We will review the efficacy and tolerability of atypical antipsychotics versus conventional antipsychotics and/or benzodiazepines as a first-line treatment, and examine the suitability of oral versus intramuscular formulations in the acute setting. The potentially beneficial properties of specific atypical agents are also considered. Appropriate dosing is particularly important in acutely ill patients as it can help achieve rapid improvement. We will discuss emerging data which show that rapid initiation of quetiapine in patients with acute psychosis or mania is not only as effective as standard initiation, but is also well tolerated. This may be important for treatment in the long term as a positive initial treatment experience can determine patient compliance and treatment adherence. In conclusion, this review recommends that oral atypical antipsychotics should be a first-choice medication for acutely ill cooperative patients in the hospital setting.
authors.affiliation: University Psychiatric Centre KU Leuven, Campus St.-Jozef Kortenberg, Leuven, Belgium.
authors.forename: Joseph
authors.initials: J
authors.lastname: Peuskens
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.forename: Pier
authors.initials: P
authors.lastname: Luca Bandinelli
authors.forename: Markus
authors.initials: M
authors.lastname: Gastpar
authors.forename: Nicholas
authors.initials: N
authors.lastname: Keks
authors.forename: Sheena
authors.initials: S
authors.lastname: Mitchell
authors.forename: Timuçin
authors.initials: T
authors.lastname: Oral
authors.forename: Kristina
authors.initials: K
authors.lastname: Timdahl
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
keywords: Schizophrenia; acute disease; bipolar disorder; quetiapine