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Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review

INTRODUCTION: Quetiapine fumarate is an atypical antipsychotic approved for the treatment of schizophrenia, major depressive disorder, and bipolar disorder. Due to the sedative effects observed at low doses, prescribers use quetiapine to aid patients with sleep disturbances. Current evidence has est...

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Autores principales: Carr, Chelsea N., Lopchuk, Shruti, Beckman, Mary E., Baugh, Terrence Bradley
Formato: Online Artículo Texto
Lenguaje:English
Publicado: College of Psychiatric & Neurologic Pharmacists 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007538/
https://www.ncbi.nlm.nih.gov/pubmed/29955487
http://dx.doi.org/10.9740/mhc.2016.11.308
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author Carr, Chelsea N.
Lopchuk, Shruti
Beckman, Mary E.
Baugh, Terrence Bradley
author_facet Carr, Chelsea N.
Lopchuk, Shruti
Beckman, Mary E.
Baugh, Terrence Bradley
author_sort Carr, Chelsea N.
collection PubMed
description INTRODUCTION: Quetiapine fumarate is an atypical antipsychotic approved for the treatment of schizophrenia, major depressive disorder, and bipolar disorder. Due to the sedative effects observed at low doses, prescribers use quetiapine to aid patients with sleep disturbances. Current evidence has established that quetiapine can cause negative changes in metabolic parameters, but it is unknown if these consequences also occur at low doses. Due to the use of quetiapine for sleep, the purpose of this study is to identify if metabolic effects are also a risk with the use of low-dose quetiapine. METHODS: Eligible subjects were identified through the Veterans Affairs electronic medical records as having an active prescription for quetiapine from June 30, 2012, through September 1, 2013. Subjects were then evaluated using inclusion and exclusion criteria for determination of study entrance. Descriptive statistics and t tests were utilized to identify clinical and statistical differences in outcomes. RESULTS: A total of 403 subjects were included in the final analysis. The average dose of quetiapine was 116.8 mg and average duration of therapy was 44 months. Increases were observed in systolic blood pressure (+1.95 mmHg; P = .036), diastolic blood pressure (+1.97 mmHg; P = .001), body mass index (+0.52; P = .001), weight (+1.88 kg; P = .002), and fasting blood glucose (+6.71 mg/dL; P = .002). Conversely, a decrease in total cholesterol (−10.06 mg/dL; P < .001) was recognized. DISCUSSION: As a result of the findings, there may be negative metabolic consequences with the use of low-dose quetiapine. Routine prescribing of low doses for sleep as a first-line medication should be avoided.
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spelling pubmed-60075382018-06-28 Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review Carr, Chelsea N. Lopchuk, Shruti Beckman, Mary E. Baugh, Terrence Bradley Ment Health Clin Open Submissions INTRODUCTION: Quetiapine fumarate is an atypical antipsychotic approved for the treatment of schizophrenia, major depressive disorder, and bipolar disorder. Due to the sedative effects observed at low doses, prescribers use quetiapine to aid patients with sleep disturbances. Current evidence has established that quetiapine can cause negative changes in metabolic parameters, but it is unknown if these consequences also occur at low doses. Due to the use of quetiapine for sleep, the purpose of this study is to identify if metabolic effects are also a risk with the use of low-dose quetiapine. METHODS: Eligible subjects were identified through the Veterans Affairs electronic medical records as having an active prescription for quetiapine from June 30, 2012, through September 1, 2013. Subjects were then evaluated using inclusion and exclusion criteria for determination of study entrance. Descriptive statistics and t tests were utilized to identify clinical and statistical differences in outcomes. RESULTS: A total of 403 subjects were included in the final analysis. The average dose of quetiapine was 116.8 mg and average duration of therapy was 44 months. Increases were observed in systolic blood pressure (+1.95 mmHg; P = .036), diastolic blood pressure (+1.97 mmHg; P = .001), body mass index (+0.52; P = .001), weight (+1.88 kg; P = .002), and fasting blood glucose (+6.71 mg/dL; P = .002). Conversely, a decrease in total cholesterol (−10.06 mg/dL; P < .001) was recognized. DISCUSSION: As a result of the findings, there may be negative metabolic consequences with the use of low-dose quetiapine. Routine prescribing of low doses for sleep as a first-line medication should be avoided. College of Psychiatric & Neurologic Pharmacists 2016-11-03 /pmc/articles/PMC6007538/ /pubmed/29955487 http://dx.doi.org/10.9740/mhc.2016.11.308 Text en © 2016 CPNP. http://creativecommons.org/licenses/by-nc/3.0/ The Mental Health Clinician is a publication of the College of Psychiatric and Neurologic Pharmacists. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Open Submissions
Carr, Chelsea N.
Lopchuk, Shruti
Beckman, Mary E.
Baugh, Terrence Bradley
Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review
title Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review
title_full Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review
title_fullStr Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review
title_full_unstemmed Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review
title_short Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review
title_sort evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: a retrospective review
topic Open Submissions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007538/
https://www.ncbi.nlm.nih.gov/pubmed/29955487
http://dx.doi.org/10.9740/mhc.2016.11.308
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