Quetiapine in relapse prevention in alcoholics suffering from craving and affective symptoms: a case series

Croissant, Bernhard; Klein, Oliver; Gehrlein, Lea-Marie; Kniest, Anja; Hermann, Derik; Diehl, Alessandra; Mann, Karl

doi:10.1016/j.eurpsy.2006.04.007

Cited by 28 publications

(22 citation statements)

References 26 publications

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“…These findings extend the clinical literature suggesting that quetiapine may be effective for the treatment of alcohol dependence. These results are consistent with previous reports of quetiapineinduced blunting of alcohol craving, both in open-label studies (Croissant et al 2006;Martinotti et al 2008;Sattar et al 2004) and in a placebo-controlled trial (Kampman et al 2007). While the results for alcohol craving are clearly supportive of the potential clinical utility of quetiapine for alcoholism treatment, the findings for subjective intoxication and sedation lend themselves to alternative explanations.…”

Section: Discussionsupporting

confidence: 92%

“…An additional chart review of nine patients admitted to a residential rehabilitation program suggested that quetiapine was well tolerated and associated with significant decreases in anxiety, improvements in sleep, and lower craving for alcohol (Sattar et al 2004). Published single-case (Lindberg et al 2006) and observational studies (Croissant et al 2006) suggested that quetiapine was well tolerated and may be effective in treating alcoholism. An open-label study of quetiapine in patients with comorbid schizophrenia-spectrum and substance use disorders suggested that the severity of substance abuse decreased over the course of a 12-week trial of quetiapine, as indicated by reduced number of substance use days and money spent on alcohol/drugs (Potvin et al 2006).…”

Section: Introductionmentioning

confidence: 95%

“…Although reports from clinical observation, case studies, and retrospective chart reviews have suggested that quetiapine may reach its clinical effects for alcoholism by reducing alcohol craving (Croissant et al 2006), improving sleep (Lindberg et al 2006;Monnelly et al 2004), and increasing sedation/decreasing anxiety (Sattar et al 2004), no experimental studies to date have examined the mechanisms of action of this pharmacotherapy. As recently reviewed, knowledge of the mechanisms of action of quetiapine may improve the available treatments for alcoholism by: (1) informing targeted interventions that are guided by the pharmacotherapy's mechanisms and assessment of the patient's needs; (2) elucidating the underlying pathophysiology of alcohol dependence itself; and (3) informing efforts to combine pharmacotherapies on the basis of their neurobiological and biobehavioral effects (Ray et al 2010a).…”

Section: Introductionmentioning

confidence: 99%

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A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving

et al. 2011

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving

et al. 2011

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“…Obwohl in der Mehrzahl der durchgeführten Studien keine positiven E ekte belegt werden konnten, fanden sich in einigen Fallserien Hinweise auf Anticravingeigenscha en des atypischen Antipsychotikums Quetiapin [55,56].…”

Section: Weitere Ansätzeunclassified

Wichtige Ergänzung zur Rezidivprophylaxe und Trinkmengenreduktion

Schicho

Pogarell

2013

DNP

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Bei der Behandlung der Alkoholabhängigkeit werden mit quali zierter Entgiftung und suchtspezi scher Therapie Abstinenzraten von 40 -70 % erzielt. Trotzdem ist die langfristige Erfolgsrate hinsichtlich dauerhafter Abstinenz gering. Zum Entzug, zur Rezidivprophylaxe sowie zur Trinkmengenreduktion stellen pharmakotherapeutische Strategien eine wichtige Ergänzung psychotherapeutischer und psychosozialer Therapien dar. A lkoholabhängigkeit hat in westlichen Ländern eine Lebenszeitprävalenz von 7-12,5 % [1, 2]. Im weltweiten Vergleich weist die europäi-sche Region die höchste Rate an durch Alkohol verursachten Todesfällen auf. Insgesamt handelt es sich dabei um 6,5 % [3]. Gesundheitsökonomisch und sozialmedizinisch stellt Alkoholmissbrauch eines der wichtigsten Probleme dar. Bei einem bedeutenden Anteil der Bevölkerung besteht diesbezüglich Beratungsbedarf [4]. Die Notwendigkeit gezielter Behandlungskonzepte ist angesichts dieser Zahlen o ensichtlich. BehandlungsstrategienDer Alkoholabhängigkeit liegt unter anderem eine gestörte Kontrolle des Trinkverhaltens (Kontrollverlust) zugrunde. Es kann bei Alkoholabhängigen selbst nach mehreren Jahrzehnten der Abstinenz zu Rückfällen kommen, wie in vielen Studien belegt wurde [5]. Dauerha e Abstinenz ist in den Augen der meisten Kliniker weiterhin das Hauptziel in der Behandlung alkoholabhängiger Patienten, allerdings ist auch die Reduktion der Trinkmenge (im Sinne einer "harm reduction") ein immer häu ger diskutiertes Ziel [6]. Für manche Patienten kommt aus verschiedenen Gründen eine abstinenzorientierte Behandlung aktuell nicht infrage; für diese sollte daher ein alternatives Konzept angeboten werden können [7]. Patienten in die Behandlungsplanung einzubeziehen und ihnen zu ermöglichen, über infrage kommende individuelle erapieziele selbst zu entscheiden -Abstinenz als langfristiges Ziel und/oder Trinkmengenreduktion als erster Schritt -, könnte die erapiemotivation steigern und zu besseren Ergebnissen führen [8]. Bis heute ist allerdings die Datenlage heterogen, ob und inwiefern "kontrolliertes Trinken" eine e ektive erapiestrategie in der Behandlung der Alkoholabhängigkeit darstellt und ob dies angesichts des meist vorliegenden Abhängigkeitsmerkmals des "Kontrollverlusts" überhaupt mög-lich ist [9]. Studien deuten an, dass die meisten alkoholabhängigen Patienten nicht in der Lage sind, über längere Zeit kontrolliert zu trinken, sodass abstinenzorientierte erapieangebote langfristig nach wie vor im Vordergrund stehen [10].Zur erfolgreichen erapie alkoholabhängiger Patienten ist ein interdisziplinä-res Netzwerk von Haus-und Fachärzten sowie spezialisierten Institutionen erforderlich. Grundlage jeder erapie ist die © Photos.com plus Ob "kontrolliertes Trinken" überhaupt möglich ist, wird kontrovers diskutiert.

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“…Another atypical antipsychotic drug, quetiapine, has been evaluated in a case study [160] and an open-label study [161] in patients with alcohol dependence and comorbid psychiatric diagnosis. Both studies demonstrated that quetiapine was well tolerated and in the latter study, the medication not only reduced alcohol consumption and overall psychiatric symptom intensity but also significantly reduced craving.…”

Section: Clinical Evidence For the Use Of Atypical Dopamine D2 Antagomentioning

confidence: 99%

Dopamine and Alcohol Dependence: From Bench to Clinic

Jayaram‐Lindström¹,

Ericson²,

Steensland³

et al. 2016

Recent Advances in Drug Addiction Research and Clinical Applications

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Alcohol dependence, a chronic relapsing psychiatric disorder, is a major cause of mortality and morbidity. The role of dopamine in alcohol-induced reward as well in the development of alcohol dependence is reviewed herein. Both preclinical and clinical studies have suggested that alcohol activates the mesolimbic dopamine system (defined as a dopamine projection from the ventral tegmental area (VTA) to the nucleus accumbens (NAc, i.e. ventral striatum)) leading to a euphoric sensation. Alcohol dependence is characterized by a disruption in the reward-related brain areas including fewer dopamine D2 receptors in ventral striatum. Investigations of the underlying dopaminergic mechanisms involved during the development and maintenance of alcohol dependence could identify novel targets. Human and rodent experimental studies show that dopamine receptor antagonists, agonists and partial agonists as well as dopamine stabilizers influencing dopamine transmission, alter alcohol-mediated behaviours and thus may be potential treatment targets for alcohol dependence. Although there exists promising preclinical results, the majority of placebo-controlled randomized clinical trials with traditional dopamine antagonists and agonists have so far have been discouraging. Furthermore, the severe side-effect profiles of many of these compounds may limit their clinical use. Newer dopamine agents, such as partial agonists and dopamine stabilizers, attenuate alcohol-mediated behaviours in rodents as well as humans. Preclinical as well as clinical studies have shown that substances indirectly targeting the mesolimbic dopamine system may be potential targets for attenuation of alcohol reward. Collectively, the data reviewed herein may contribute to further understanding the complex mechanisms involved in development of alcohol dependence and we suggest that the newer dopamine agents as well as indirect modulators of dopamine signalling deserve to be further evaluated for treatment of alcohol dependence.

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Quetiapine in relapse prevention in alcoholics suffering from craving and affective symptoms: a case series

Abstract: Although uncontrolled case observations can only be interpreted with caution quetiapine seems to deserve further investigation and may hold the potential for preventing alcohol relapse in alcoholics suffering from additional above-mentioned symptoms.

Cited by 28 publications

References 26 publications

A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving

A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving

Wichtige Ergänzung zur Rezidivprophylaxe und Trinkmengenreduktion

Dopamine and Alcohol Dependence: From Bench to Clinic

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