Quetiapine in Patients With Schizophrenia

Small, Joyce G.; Hirsch, Steven R.; Arvanitis, L.A.; Miller, B.G.; Link, C.G.G.

doi:10.1001/archpsyc.1997.01830180067009

Cited by 429 publications

(50 citation statements)

References 17 publications

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“…For the BPRS total score, first a superiority test was done and, if the null hypothesis was not rejected, a secondary non-inferiority hypothesis was tested with a non-inferiority limit set at six points considered clinically relevant with regards to the placebo-active drug difference generally observed (Chouinard et al 1993;Marder and Meibach 1994;Beasley et al 1996a,b;Van Kammen et al 1996;Arvanitis et al 1997;Small et al 1997;Zimbroff et al 1997;Peuskens et al 1999). All other efficacy parameters were analyzed using 2-sided tests for superiority.…”

Section: Discussionmentioning

confidence: 99%

Amisulpride vs. Risperidone in Chronic Schizophrenia Results of a 6-month Double-blind Study

Sechter

Fleurot

Rein

et al. 2002

Neuropsychopharmacology

106

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Schizophrenia is a chronic and disabling disorder with a lifetime prevalence of approximately 1% (American Psychiatric Association 1994). It results in significant long-term functional handicap, severely impairs the quality of life of both the patient and the caregivers and places a considerable financial burden on society.The clinical efficacy of amisulpride against acute psychotic symptoms at high doses (400-800 mg/day) and prominent negative symptoms at low doses (50-300 mg/day) may be explained by its preferential affinity for pre-synaptic dopaminergic D 2 and D 3 autoreceptor subtypes at low doses, while higher doses result in predominant antagonism of post-synaptic dopamine receptors (Perrault et al. 1997;Schoemaker et al. 1997). It also shows selectivity for dopamine receptors in limbic and hippocampal structures, rather than striatal structures, thus suggesting a lower propensity to induce extrapyramidal effects than seen with the classical antipsychotics (Perrault et al. 1997). Studies in

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Section: Discussionmentioning

confidence: 99%

Amisulpride vs. Risperidone in Chronic Schizophrenia Results of a 6-month Double-blind Study

Sechter

Fleurot

Rein

et al. 2002

Neuropsychopharmacology

106

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“…However, there have been several studies that have examined the effect of antipsychotics or adjunctive agents for persistent negative symptoms. In these studies, when an effect has been observed, it has always been observed within the time frame of the current study (Paillère-Martinot et al 1995;Heresco-Levy et al 1996;Goff et al 1995b;Marder and Meibach 1994;Tollefson et al 1997;Small et al 1997).…”

Section: Discussionmentioning

confidence: 60%

Mazindol Treatment of Negative Symptoms

Carpenter

2000

Neuropsychopharmacology

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Hypodopaminergic and hyponoradrenergic pathophysiology may be a basis for primary and/or secondary negative symptoms in schizophrenia. The hypothesis that enhanced neurotransmission in these systems would be therapeutic for negative symptoms was tested by comparing mazindol and placebo in a double-blind, cross-over design trial. Outcome following mazindol supplementation was comparable to placebo supplementation (F(1,30) Many mental and physical states can temporarily reduce an individual's ability to experience pleasure, gratification, and reinforcement. However, when Rado (1956) described anhedonia as a core feature of schizophrenia, he referred to an enduring or trait reduction in capacity rather than a transitory or state impairment. Meehl (1962) elaborated this concept in the context of a trait neurointegrative disability associated with schizophrenia. Stein and Wise (1971) subsequently introduced the hypothesis that neurotoxic damage to the noradrenergic reward system was present in schizophrenia. This latter theory, while not capable of accounting for the broad range of clinical manifestations of the disease, seemed a highly cogent hypothesis for anhedonia per se (Strauss and Carpenter 1972).Negative symptoms of schizophrenia are defined more broadly than anhedonia, but the core features of reduced social drive, restricted emotional experience and expression, alogia, and a diminished capacity for the experience of pleasure are hypothesized to emerge from pathophysiology in the neural circuits concerned with drive, emotion, and reward. Dopaminergic and noradrenergic neurons are central to the mediation of these experiences (Schultz 1997).These considerations suggest a therapeutic hypothesis, that enhanced neurotransmission in noradrenergic and/or dopaminergic systems would be therapeutic for negative symptoms. In particular, the dopaminergic mesocortical projections and noradrenergic circuitry involved with reward are seen as possible neural substrates for the negative symptoms of schizophrenia (Weinberger 1987;Davis et al. 1991). Developing a treatment based on either of these presumptions is not straightforward, however, since the hyperdopaminergic mesolimbic hypothesis would predict that a drug that reduces negative symptoms would have the potential liability of increasing positive symptoms.An approach to enhancing mesocortical dopaminergic activity, while having little effect on other projections, is the use of dopamine reuptake inhibitors. This approach is based on the observation that dopamine NO . 4 turnover rates in the mesocortical projection are two to four fold higher than in the mesolimbic or nigrostriatal systems (Agnati et al. 1980;Bannon et al. 1981;Thierry et al. 1976). Accordingly, a reuptake blocker should result in a faster accumulation and higher concentration of synaptic dopamine in cortical regions than in other dopamine terminal fields. Direct support for this hypothesis is provided by preclinical studies in which drugs that block amine transporters increase dopamine levels in ...

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“…Quetiapine fumarate is a serotonine and dopamine receptor antagonist used to treat schizophrenia and belongs to the same family as clozapine and olanzapine, which are classified as atypical antipsychotics [1]. Its chemical designation is 2-(2- [4-(dibenzo[b,f] [1,4]thiazepine-11-yl)piperazin-1-yl]ethoxy) ethanol fumarate (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…Its chemical designation is 2-(2- [4-(dibenzo[b,f] [1,4]thiazepine-11-yl)piperazin-1-yl]ethoxy) ethanol fumarate (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

A validated stability-indicating RP-LC method for the estimation of process-related impurities and degradation products of quetiapine fumarate in solid oral dosage form

Kumar

Sangeetha²,

Goyal

et al. 2013

Acta Chromatographica

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Summary.A simple, selective, and stability-indicating reverse phase liquid chromatographic method has been developed and validated for the simultaneous determination of impurities and forced degradation products of quetiapine fumarate. The chromatographic separation was achieved on Inertsil-3 C8, 150 mm × 4.6 mm, 5 μm column at 35°C with UV detection at 217 nm using gradient mobile phase at a flow rate of 1.0 mL/min. Mobile phase A contains a mixture of 0.01 M di-potassium hydrogen orthophosphate (pH 6.8) and acetonitrile in the ratio of 80:20 (v/v), respectively, and mobile phase B contains a mixture of 0.01 M di-potassium hydrogen orthophosphate (pH 6.8) and acetonitrile in the ratio of 20:80 (v/v), respectively. The drug product was subjected to the stress conditions of oxidative, hydrolysis (acid and base), hydrolytic, thermal, and photolytic degradation. Quetiapine fumarate was found to degrade significantly in acid, base, and oxidative stress conditions. The degradation products were well resolved from main peak and its impurities. The mass balance was found to be in the range of 96.6-102.2% in all the stressed conditions, thus proved the stability-indicating power of the method. The developed method was validated as per ICH guidelines with respect to specificity, linearity, limit of detection and quantification, accuracy, precision, and robustness.

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Quetiapine in Patients With Schizophrenia

Abstract: Quetiapine is an effective antipsychotic with a favorable safety profile. The optimum dose is probably greater than 250 mg/d.

Cited by 429 publications

References 17 publications

Amisulpride vs. Risperidone in Chronic Schizophrenia Results of a 6-month Double-blind Study

Amisulpride vs. Risperidone in Chronic Schizophrenia Results of a 6-month Double-blind Study

Mazindol Treatment of Negative Symptoms

A validated stability-indicating RP-LC method for the estimation of process-related impurities and degradation products of quetiapine fumarate in solid oral dosage form

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