What makes 75 mg of Seroquel
Retarded quetiapine in acute and long-term therapy
Quetiapine is an atypical neuroleptic that is successfully used in the therapy of schizophrenia. So far, however, the regime has not been very comfortable for doctors and patients. The drug had to be taken several times a day, increasing the dose was difficult and the necessary maintenance dose was often only reached after a few days. As a result, the dose was often too cautious and the effect was not immediately noticeable. These problems are now being resolved with the introduction of retarded quetiapine (Seroquel® Prolong), which was approved at the end of January 2008 by the Federal Institute for Drugs and Medical Devices for acute therapy and relapse prevention of adult schizophrenia patients. "The new formulation combines very good active properties and a very good tolerance profile with a rapid increase in dosage and a single daily dose," said Prof. Dr. Hans-Jürgen Möller, Director of the Psychiatric Clinic at LMU Munich, the advantages in a nutshell.
With the simple dosing scheme, starting with 300 mg on the first day (previously: 50 mg), the recommended daily dose of 600 mg is already reached on the second day. In medically justified cases, the daily dose can be increased to 800 mg. Patient compliance is facilitated by the single daily dose at night. An aspect that is particularly important in schizophrenia therapy. Because non-compliance is the greatest risk factor for a relapse. 81% of patients with schizophrenia who stop taking the antipsychotic will have a relapse within the next five years. It is important that the drug is not taken with a meal. According to the specialist information, the time interval should be at least one hour.
Studies prove effectiveness and tolerability
The retarded quetiapine formulation has been investigated in various clinical studies for efficacy and tolerability, namely in acute therapy, in relapse prophylaxis and as part of a changeover. In acute schizophrenia, in a randomized double-blind study with 588 patients, the PANSS (positive and negative symptom scale) score was significantly reduced in all dosages used within six weeks, namely by 24.8 points below 400 mg / day, by 30.9 Points below 600 mg / day and by 31.3 points below 800 mg / day (placebo: 18.8 points). The CGI (clinical global impression) scores also showed advantages over placebo. The effectiveness in preventing relapse was shown in 197 patients who had already responded well to retarded quetiapine in acute therapy. The likelihood of relapse after six months was 14.3% compared to 68.2% with placebo. That means a risk reduction of 84%. Even patients who do not respond adequately to their previous antipsychotic medication can benefit from switching to slow-release quetiapine. This was shown in a twelve-week, multicenter, open-label study in 477 patients with schizophrenia. 315 patients were switched because of ineffectiveness, the others because of insufficient tolerance of the previous medication. The overall clinical impression improved in almost two thirds. The PANSS score as a measure of positive and negative symptoms also decreased, regardless of the previous medication.
Seroquel® and Seroquel® Studies have shown that Prolong is equivalent in terms of effect and dosage. Retarded quetiapine at a dose of 600 mg once daily is as effective as 300 mg fast-released quetiapine twice daily. Switching from the previous rapid-release Seroquel®-Film tablets on retarded quetiapine is problem-free. The total daily dose is then equivalent and is taken once a day. A dose adjustment may be necessary in individual cases.
Prof. Dr. Hans-Jürgen Möller, Munich: "New therapy option in schizophrenia treatment: Seroquel® Prolong for a daily single dose ", Munich, February 26, 2008, organized by AstraZeneca GmbH, Wedel.
Pharmacist Dr. Beate Fessler
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