Efficacy of Quetiapine in the Treatment of Patients With Schizophrenia and a Comorbid Substance Use Disorder
Condition: Schizophrenia; Schizoaffective Disorder; Psychotic Disorder; Substance Abuse; Alcohol Abuse
MeSH terms: Substance-Related Disorders; Alcoholism; Schizophrenia; Psychotic Disorders
Intervention: Quetiapine
Intervention description: After patients provided informed consent and completed baseline measures, quetiapine was initiated in all participants and titrated up to a target dose of 600 mg (in divided daily doses) over two weeks as the previous antipsychotic medication was slowly tapered and discontinued. Participants met with study physicians weekly to assess tolerability and response to the medication. Concomitant medications were held constant. After the initial titration period, quetiapine was dosed in a flexible manner up to 800 mg /day, with dose adjustments based on symptomatic response and side effects.
Intervention MeSH terms: Quetiapine Fumarate
Phase: Phase 4
Study type: Interventional
Primary purpose: Other
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 23.0
Sex: All
Minimum age: 18 Years
Maximum age: 65 Years
Healthy volunteers: No
Keywords: Quetiapine; Seroquel; Schizophrenia; Dual Diagnosis; Substance Abuse; Alcohol Abuse

Summary:

      The purpose of this study is to examine the efficacy of quetiapine (Seroquel) in reducing
      substance use in persons diagnosed with schizophrenia. The primary hypothesis is that
      quetiapine treatment will be associated with a decrease in substance use.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Age 18-65

          -  Schizophrenia or schizoaffective disorder

          -  Meets Structured Clinical Interview for Diagnostic and Statistical Manual of Mental
             Disorders, Fourth Edition (SCID) criteria for a substance use disorder (alcohol use
             disorder [AUD]; abuse or dependence)

          -  Active substance use on at least 8 days during the 4 weeks prior to randomization.

          -  Current treatment with antipsychotic medication.

          -  Able to provide informed consent, or in the case of patients with legal court
             appointed guardians willing to give assent, with the consent of the guardian.

          -  Not actively suicidal.

        Exclusion Criteria:

          -  Current treatment with, decanoate antipsychotic, clozapine, or doses of quetiapine not
             approved by the team of investigators. Individuals treated with depot antipsychotic
             must wait until the end of their injection cycle before starting on study medication.

          -  Currently pregnant, planning to become pregnant, or unwilling to use an acceptable
             form of birth control.

          -  Currently residing in a residential program designed to treat substance use disorders.

          -  Treatment at baseline with a psychotropic agent proposed to curtail substance use.

          -  Patients who, in the opinion of the investigator, are judged unsuitable to participate
             in the study.

          -  Unable to take part in the assessments in a meaningful way

          -  Hypersensitivity/intolerance to quetiapine

          -  Serious, unstable medical condition

          -  Participation in clinical trial of an investigational drug within 30 days of baseline
             visit, or concurrent participation in a treatment study of a psychosocial intervention