TY - JOUR
T1 - Systematic literature review of quetiapine for the treatment of psychosis in patients with Parkinsonism
AU - Chen, Jack J.
AU - Hua, Henry
AU - Massihi, Lilian
AU - Portillo, Ivan
AU - Alipour, Azita
AU - Ondo, William
AU - Dashtipour, Khashayar
N1 - Funding Information:
Dr. Chen has served on the advisory board for Neurocrine Biosciences and received research funding from Lundbeck LLC. Dr. Ondo has served as a speaker for or consultant to Acadia Pharmaceuticals, Adamas Pharmaceuticals, Neurocrine Biosciences, Sunovion Pharmaceuticals, Teva Pharmaceutical Industries, and US WorldMeds; and he has received grant support from Biotie, Luitpold, Lundbeck LLC, Sunovion Pharmaceuticals, and Tremor Research Group. Dr. Dashtipour has received honorarium to serve as a consultant and speaker for AbbVie, Acadia Pharmaceuticals, Adamas Pharmaceuticals, Allergan, Impax, Ipsen, Lundbeck, Merz, Neurocrine Biosciences, Sunovion Pharmaceuticals, Teva, and US WorldMeds. The other authors report no financial relationships with commercial interests.
Publisher Copyright:
© 2019, American Psychiatric Association. All rights reserved.
PY - 2019/7
Y1 - 2019/7
N2 - Objective: The purpose of this article was to determine the efficacy and tolerability of quetiapine compared with placebo or other interventions for psychosis in parkinsonism. Methods: Participants with a diagnosis of parkinsonism participated in randomized controlled trials (RCTs) investigating the efficacy and tolerability of quetiapine for psychotic symptoms within a defined follow-up period. The authors conducted searches on PubMed, Cochrane Controlled Register of Trials, and EMBASE for articles published from January 1991 to October 2017. Study methodology and patient-and treatment-level data were independently extracted and summarized by using descriptive statistics. Studies underwent quality assessment for risk of bias. Results: A total of 17,615 unique records were identified, and seven RCTs (total N=241) met inclusion criteria. Five RCTs were placebo controlled, and two compared quetiapine against clozapine. The mean study duration was 12 weeks, and the mean daily quetiapine dose was 103 mg per day (range, 12.5–300 mg). In four of five placebo-controlled RCTs, quetiapine failed to demonstrate significant improvement of psychosis in parkinsonism compared with placebo. In two clozapine-comparator RCTs, quetiapine was better tolerated but no more effective than clozapine. Across all RCTs, the mean completion rates for quetiapine, clozapine, and placebo were 66%, 68.5%, and 66%, respectively. Quetiapine did not significantly worsen motor function. Conclusions: The efficacy of quetiapine in RCTs for psychosis in parkinsonism is no better than that for placebo or clozapine. On the basis of novel data, clinicians should reevaluate traditional viewpoints on the benefits of quetiapine for psychosis in parkinsonism.
AB - Objective: The purpose of this article was to determine the efficacy and tolerability of quetiapine compared with placebo or other interventions for psychosis in parkinsonism. Methods: Participants with a diagnosis of parkinsonism participated in randomized controlled trials (RCTs) investigating the efficacy and tolerability of quetiapine for psychotic symptoms within a defined follow-up period. The authors conducted searches on PubMed, Cochrane Controlled Register of Trials, and EMBASE for articles published from January 1991 to October 2017. Study methodology and patient-and treatment-level data were independently extracted and summarized by using descriptive statistics. Studies underwent quality assessment for risk of bias. Results: A total of 17,615 unique records were identified, and seven RCTs (total N=241) met inclusion criteria. Five RCTs were placebo controlled, and two compared quetiapine against clozapine. The mean study duration was 12 weeks, and the mean daily quetiapine dose was 103 mg per day (range, 12.5–300 mg). In four of five placebo-controlled RCTs, quetiapine failed to demonstrate significant improvement of psychosis in parkinsonism compared with placebo. In two clozapine-comparator RCTs, quetiapine was better tolerated but no more effective than clozapine. Across all RCTs, the mean completion rates for quetiapine, clozapine, and placebo were 66%, 68.5%, and 66%, respectively. Quetiapine did not significantly worsen motor function. Conclusions: The efficacy of quetiapine in RCTs for psychosis in parkinsonism is no better than that for placebo or clozapine. On the basis of novel data, clinicians should reevaluate traditional viewpoints on the benefits of quetiapine for psychosis in parkinsonism.
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U2 - 10.1176/appi.neuropsych.18080180
DO - 10.1176/appi.neuropsych.18080180
M3 - Article
C2 - 30848989
AN - SCOPUS:85073397461
SN - 0895-0172
VL - 31
SP - 188
EP - 195
JO - Journal of Neuropsychiatry and Clinical Neurosciences
JF - Journal of Neuropsychiatry and Clinical Neurosciences
IS - 3
ER -