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New Study Shows Equivalent Efficacy and
Superior Tolerability of Quetiapine Compared
to Risperidone in the Treatment of
Schizophrenia
04 de janeiro de 2006 11:34 HORALOCAL
New Study Shows Equivalent Efficacy and
Superior Tolerability of Quetiapine Compared
to Risperidone in the Treatment of
Schizophrenia
MUNICH, Germany, Jan. 4 /PRNewswire/ -- A
new study published today in the European
Archives of Psychiatry and Clinical
Neuroscience demonstrates that quetiapine (SEROQUEL)
and risperidone (RISPERDAL) have equivalent
efficacy in the treatment of patients with
schizophrenia exhibiting predominately
negative symptoms, however quetiapine showed
superior tolerability especially with
respect to extrapyramidal symptoms (EPS).(1)
(Logo: http://www.newscom.com/cgi-bin/prnh/20060104/197690
)Schizophrenia is one of the most
debilitating chronic illnesses, affecting
approximately 1% of the world population.(2)
Negative symptoms such as reduced drive and
motivation, loss of ability to feel and
express emotion (affective blunting), and
reduced interest in taking part in
activities (asociality and apathy),
inability to experience pleasure (anhedonia),
lack of initiative and energy (avolition)
and impairment of speech (alogia) can
significantly impact patient function and
quality of life. Although existing
treatments for schizophrenia have been shown
to address these negative symptoms, one of
the key issues that impacts positive
treatment outcome is patient adherence to
medication, which is often influenced by
side effects. This double-blind, randomized
comparative study investigates efficacy and
importantly the tolerability of two
schizophrenia medications.
The study investigator, Dr Michael Riedel,
M.D., Ludwig-Maximilian-University Munich,
Germany, commented: "One of the key issues
in treating patients with schizophrenia is
achieving a good quality of life by
balancing efficacy and tolerability of
medication. Negative symptoms associated
with schizophrenia are less responsive to
treatment. This small, but tightly
controlled pilot study shows that quetiapine
and risperidone have the same efficacy in
patients with schizophrenia exhibiting
mainly negative symptoms, but only
quetiapine shows a statistically significant
effect on treating alogia and affective
blunting compared to baseline. Importantly
there are significant differences in the
tolerability between both medications;
quetiapine was superior in many tolerability
parameters including EPS. To patients, a
reduction in EPS really matters in terms of
quality of life. Medication with less EPS
therefore may help address patient
compliance issues by achieving the best
balance of treatment efficacy and superior
tolerability."Patients with schizophrenia
presenting with predominantly negative
symptoms were treated with quetiapine (mean
dose 589.7 mg/day) or risperidone (mean dose
4.9 mg/day) over a 12 week period. Results
were as follows:
-- Patients in both treatment groups showed
significant improvements in the PANSS
(Positive and Negative Syndrome Scale)
total, positive, negative and general
psychopathology scores (P<0.01 compared to
baseline).
-- Patients in both treatment groups
experienced significant reduction in
negative symptoms as early as week one (P
less than or equal to 0.01) and this
improvement continued up to week 12 (P less
than or equal to 0.01 for all time points).
-- At week 12, both medications also
achieved significant improvements on some
parameters of the Assessment of Negative
Symptoms (SANS) scale (quetiapine P<0.001
and risperidone P<0.01 compared to baseline),
however only quetiapine demonstrated
significant improvements in alogia and
affective blunting compared to baseline (both
P<0.001).
-- Patients treated with quetiapine had a
significantly lower incidence of EPS,
including akathisia (restlessness and
inability to remain motionless) and
parkinsonism (muscle rigidity and tremor),
compared to patients treated with
risperidone (P=0.006).-- In addition, more
patients using risperidone required
anticholinergic medication to control EPS
symptoms.
-- Quetiapine also resulted in decrease of
serum prolactin levels, whilst risperidone
increased prolactin levels, which has
frequently been associated with reduction in
sexual drive and fertility.
Schizophrenia is the most common form of
severe mental illness; approximately one in
100 people develop schizophrenia during
their lifetime. There are four groups of
symptoms associated with schizophrenia:
'positive', 'negative', 'cognitive', and 'affective'.
Negative symptoms are associated with loss
or decrease of everyday functions including
drive and motivation, leading to social
withdrawal.
Notes to the Editor:
-- This study was a double-blind, randomized
comparative study enrolling 44 patients with
schizophrenia which had mainly negative
symptoms; 22 were treated with quetiapine
and 22 with risperidone.
-- Efficacy was measured by the Positive and
Negative Syndrome Scale (PANSS) score (primary
endpoint), Scale for the Assessment of
Negative Symptoms (SANS) and Clinical Global
Impression (CGI) rating scale.
-- Tolerability was measured using the
Simpson-Angus Scale (SAS) and various
laboratory measurements
References:
1. Riedel M et al. Quetiapine has equivalent
efficacy and superior tolerability to
risperidone in the treatment of
schizophrenia with predominantly negative
symptoms. Eur Arch Psychiatry Clin Neurosci
2005;255(6):432-437.
2. Buchanan RW & Carpenter WT. Schizophrenia:
introduction and overview. In: Sadock BJ,
Sadock VA, eds. Kaplan and Sadocks
Comprehensive Textbook of Psychiatry. 7th
ed. Philadelphia: Lippincott Williams and
Wilkins, 2000:1096-1110.
SOURCE Ludwig-Maximilians-University of
Munich
01/04/2006
CONTACT: Michael Riedel, riedel@med.uni-muenchen.de
or Ilja
Spellmann, Ilja.Spellmann@med.uni-muenchen.de
-
Ludwig-Maximilians-University of Munich,
Dept. of Psychiatry and
Psychotherapy, Munich, Germany,
+49-89-5160-5755, or Maren Koban,
Hill & Knowlton, +44-20-7973-4497, mkoban@hillandknowlton.com/
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