Reviews

Comparisons of the tolerability and sensitivity of quetiapine-XR in the acute treatment of schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and generalized anxiety disorder

Zuowei Wang^a1a2a3, David E. Kemp^a2, Philip K. Chan^a2, Yiru Fang^a1 c2, Stephen J. Ganocy^a2, Joseph R. Calabrese^a2 and Keming Gao^a2 c1

^a1 Department of Psychiatry, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China

^a2 Department of Psychiatry, Mood and Anxiety Clinic in Mood Disorders Program, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA

^a3 Department of Psychiatry, Hongkou District Mental Health Center of Shanghai, Shanghai, P.R. China

Abstract

Quetiapine extended-release (quetiapine-XR) has been studied in patients with schizophrenia, bipolar mania, bipolar depression, major depressive disorder (MDD), and generalized anxiety disorder (GAD). The purpose of this study was to compare the tolerability and sensitivity of quetiapine-XR among these psychiatric conditions. The discontinuation due to adverse events (DAEs) and reported somnolence in randomized, double-blind, placebo-controlled studies of quetiapine-XR in these psychiatric conditions were examined. The absolute risk reduction or increase and the number needed to treat to benefit (NNTB) or harm (NNTH) for DAEs and reported somnolence of quetiapine-XR ⩾300 mg/d relative to placebo were estimated. Data from one study in schizophrenia (n=465), one in mania (n=316), one in bipolar depression (n=280), two in refractory MDD (n=624), two in MDD (n=669) and three in GAD (n=1109) were available. The risk for DAEs of quetiapine-XR relative to placebo was significantly increased in bipolar depression (NNTH=9), refractory MDD (NNTH=8), MDD (NNTH=9), and GAD (NNTH=5), but not in schizophrenia and mania. The risk for reported somnolence of quetiapine-XR relative to placebo was significantly increased in schizophrenia (600 mg/d NNTH=15 and 800 mg/d NNTH=11), mania (NNTH=8), bipolar depression (NNTH=4), refractory MDD (NNTH=5), MDD (NNTH=5) and GAD (NNTH=5). These results suggest that patients with GAD had the poorest tolerability during treatment with quetiapine-XR, but they had a similar sensitivity as those with bipolar depression and MDD. Patients with schizophrenia or mania had a higher tolerability and a lower sensitivity than those with bipolar depression, MDD, or GAD.

(Received March 08 2010)

(Reviewed April 08 2010)

(Revised July 15 2010)

(Accepted July 26 2010)

(Online publication September 29 2010)

Key Words:

• Atypical antipsychotic;
• bipolar disorder;
• generalized anxiety disorder;
• major depressive disorder;
• schizophrenia

Correspondence:

^c1 Address for correspondence: Dr K. Gao, 10524 Euclid Avenue, 12th floor, Cleveland, OH 44106, USA. Tel.: 1-216-844-2656 Fax: 1-216-844-2875 Email: keming.gao@uhhospitals.org [K. Gao]

^c2 Email: yirufang@yahoo.com.cn [Y. Fang]