Treatment of a first episode of psychotic illness with quetiapine: An analysis of 2 year outcomes

Kopala, Lili C.; Good, Kimberley P.; Milliken, Heather; Buiteman, Christine; Woodley, Hazel; Rui, Qing; Whitehorn, David; Love, Leslie; Balshaw, Robert; Kiss, Ivan; Honer, William G.

doi:10.1016/j.schres.2005.09.009

« Previous Next »Schizophrenia Research
Volume 81, Issue 1 , Pages 29-39, 1 January 2006

Treatment of a first episode of psychotic illness with quetiapine: An analysis of 2 year outcomes

Lili C. Kopala
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Corresponding author. Department of Psychiatry and Center for Complex Disorders, University of British Columbia, 15521 Russell Ave, White Rock, B.C., V4B 2R4 Canada. Tel.: +1 604 535 4500x779; fax: +1 604 538 4277.
Kimberley P. Good
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
Heather Milliken
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
Christine Buiteman
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
Hazel Woodley
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
Qing Rui
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
David Whitehorn
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
Leslie Love
- Syreon Corporation, Vancouver, BC, Canada
Robert Balshaw
- Syreon Corporation, Vancouver, BC, Canada
Ivan Kiss
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
William G. Honer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

Received 27 June 2005; received in revised form 25 August 2005; accepted 1 September 2005.

Abstract

Background

The first episode of a psychotic disorder provides a unique opportunity to initiate optimal treatment but when a new medication becomes available, little data exist to guide the appropriate use in this population.

Objectives

The objectives were to determine the optimal doses and titration of quetiapine for this group and to measure outcomes (including symptom response, social functioning, mood alterations, motor symptoms, metabolic parameters and cognitive functioning) over 2 years of treatment with quetiapine.

Design

Thirty nine subjects with a first episode of psychosis referred to the Nova Scotia Early Psychosis Program in Halifax, Canada, were invited to participate in this study. Standardized clinical, laboratory, and neuropsychological assessments were performed at baseline and following treatment with quetiapine at intervals out to 2 years.

Results

Quetiapine was effective in treating the psychotic and mood symptoms while not causing extra-pyramidal signs or symptoms (EPSS). Pre-existing motor dysfunction improved. No anticholinergic medications were required. Several domains of cognitive function also improved (sustained attention, the number of perseverative errors, visuomotor speed and sequencing, verbal fluency and verbal memory). Weight gain was observed along with increases in cholesterol levels but there was no glucose dysregulation.

Conclusions

The results of this two year, naturalistic study of people with a first episode of psychosis indicated that quetiapine was well tolerated and effective for this population. Significant improvements in cognitive functioning also provided evidence for potential longer-term benefits of early and optimal treatment with this agent. However, monitoring metabolic parameters, as recommended for other atypicals, is likely prudent.

Keywords: Schizophrenia, Psychosis, Quetiapine, Antipsychotics, Cognition, Movement disorder, Metabolism