title: Long-term efficacy and tolerability of quetiapine in patients with schizophrenia who switched from other antipsychotics because of inadequate therapeutic response-a prospective open-label study.
abstract: BACKGROUND
  While the frequency and importance of antipsychotic switching in patients with schizophrenia, there is insufficient evidence with regard to switching strategy. Quetiapine is one of the drugs of choice for switch because of its unique receptor profile. However, there were no data on the long-term clinical and neurocognitive effect of quetiapine in patients who had responded inadequately to prior antipsychotics. The purpose of this study is to examine the long-term efficacy and tolerability of quetiapine in patients with schizophrenia who switched from other antipsychotics because of inadequate therapeutic response. We hypothesized that quetiapine would show long-term effectiveness in broad symptom dimensions including negative and neurocognitive symptoms while having good tolerability.
  
  
  METHODS
  Twenty-nine subjects with schizophrenia who did not respond to their current monotherapy of antipsychotic or who could not tolerate the treatment were switched to quetiapine and assessed at baseline and at 3, 6, and 12 months. The outcome measures included the brief assessment of cognition in schizophrenia (BACS), the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impressions Scale (CGI), the Schizophrenia Quality of Life Scale Japanese version (JSQLS), the Athens Insomnia Scale (AIS), and the Drug Attitude Inventory with 30 items (DAI-30). The Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS), HbA1c, prolactin (PRL), and body weight were also evaluated.
  
  
  RESULTS
  Statistically significant improvements were observed in all subscores of the PANSS, the GAF, and the symptoms and side effects subscale of the JSQLS, the DIEPSS, the AIS, and the PRL level, and nearly significant improvements were observed in the DAI-30. Quetiapine monotherapy was associated with significant improvement in the verbal memory test, even after controlling for the practice effect. Although quetiapine was well tolerated, three subjects dropped out because of the worsening of the psychotic symptoms and two additional subjects dropped out because of somnolence.
  
  
  CONCLUSIONS
  In this open-label, single-arm study of 29 patients, quetiapine improved both the clinical symptoms and the neurocognitive impairment in chronic schizophrenia patients who failed to respond to prior antipsychotic treatment.
authors: Department of Psychiatry, Hokkaido University Graduate School of Medicine, 060-8638, North 15, West 7, Kita-ku, Sapporo, Japan ; Child and Adolescent Psychiatry, Department of Psychiatry University of California, 401 Parnassus Ave, Box 0984-F, San Francisco, CA 94143 USA.
authors: Naoki
authors: N
authors: Hashimoto
authors: Department of Psychiatry, Hokkaido University Graduate School of Medicine, 060-8638, North 15, West 7, Kita-ku, Sapporo, Japan.
authors: Atsuhito
authors: A
authors: Toyomaki
authors: Honda Memorial Hospital, 061-1364, 619-1, Shimoshimamatsu Eniwa, Hokkaido, Japan.
authors: Minoru
authors: M
authors: Honda
authors: Teine Hospital, 006-0816, 8-15, Maeda 6-jo 13-chome, Teine-ku, Sapporo, Japan.
authors: Satoru
authors: S
authors: Miyano
authors: Sapporo Hanazono Hospital, 064-0915, 1-30, South 15, West 15, Chuo-ku, Sapporo, Japan.
authors: Nobuyuki
authors: N
authors: Nitta
authors: Teine Hospital, 006-0816, 8-15, Maeda 6-jo 13-chome, Teine-ku, Sapporo, Japan.
authors: Hiroyuki
authors: H
authors: Sawayama
authors: Teine Hospital, 006-0816, 8-15, Maeda 6-jo 13-chome, Teine-ku, Sapporo, Japan ; San-ai Hospital, 059-0463, 24-12, Nakanoboribetsu-cho Noboribetsu, Hokkaido, Japan.
authors: Yasufumi
authors: Y
authors: Sugawara
authors: Psychiatric Medical Center, Sapporo City General Hospital, 060-0011 1-1, North 11, West 13, Chuo-ku, Sapporo, Japan.
authors: Keiichi
authors: K
authors: Uemura
authors: Department of Psychiatry, Hakodate Watanabe Hospital, 042-0932, 1-31-1, Yunokawa Hakodate, Hokkaido, Japan.
authors: Noriko
authors: N
authors: Tsukamoto
authors: Oyachi Hospital, 004-0041, 7-10, Oyachi-higashi 5-chome, Atsubetsu, Sapporo, Japan.
authors: Tsukasa
authors: T
authors: Koyama
authors: Department of Psychiatry, Hokkaido University Graduate School of Medicine, 060-8638, North 15, West 7, Kita-ku, Sapporo, Japan.
authors: Ichiro
authors: I
authors: Kusumi
keywords: Antipsychotic; Cognitive impairment; Negative symptom; Quetiapine; Schizophrenia; Switching; Treatment resistance
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