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| |  DG DISPATCH - ECNP: No Weight Gain With Seroquel In Schizophrenics By Olwen Glynn Owen Special to DG News LONDON, UK -- September 24, 1999 -- Schizophrenic patients who gain weight and develop diabetes while taking antipsychotic therapy may be able to reverse this effect by partially substituting Seroquel (quetiapine), a more recent atypical antipsychotic.
The findings of a recent study were reported by researchers Michael Reinstein and colleagues from the Forest Foundation, Chicago, IL, at the 12th congress of the European College of Neuropsychopharmacology, held London, UK, 21-15 September. The observation that quetiapine induces weight loss and improves glycaemic control in patients who put on weight and developed diabetes whilst taking clozapine was unexpected but welcome, say the researchers. They have now conducted a retrospective, 10-month, open-label, non-randomised study to assess changes in weight and diabetes status of patients originally treated with clozapine who switched to a combination of clozapine plus quetiapine. Monthly-compiled body weight charts were obtained for 65 randomly selected schizophrenic patients treated originally with clozapine 200-800 milligrams/day for six months and who then substituted quetiapine for 25 percent of their clozapine dosage. For every 1-mg of clozapine withdrawn, 2 mg of quetiapine was added. The combined clozapine-quetiapine regimen was then administered for 10 months. Quetiapine dosages ranged from 200-800 mg/day. Results show all 65 patients lost weight progressively over the 10 months with an average weight loss of 4.2kg. The 20 percent who had developed diabetes on clozapine showed significant improvement once quetiapine was added. All changes were statistically significant (p<0.001) and all patients were highly satisfied. There was 100 percent compliance and no significant adverse events were observed, although drowsiness was a common complaint,correctable by dose adjustment. The researchers comment that clozapine and other antipsychotic drugs can cause pronounced weight gain. The problem is serious prompting distress and reluctance to comply with medication among some patients. "Every effort should be made to prevent or vigorously treat it." Clinical observations that quetiapine can reverse weight gain and improve diabetes are worthy of proper investigation in well-controlled trials, they conclude. Reinstein, MJ et al. Addition of quetiapine to clozapine therapy reverse clozapine-induced weight gain and improves diabetes management. European Neuropsychopharmacology 1999; 9 (supplement 5): S267.
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