Sections
History and Discovery | Structure–Activity Relations | Pharmacokinetics and Disposition | Indications and Efficacy | Side Effects and Toxicology | Conclusion | References
Excerpt
Quetiapine is a second-generation antipsychotic (SGA) developed
and subsequently marketed by AstraZeneca. In preclinical trials,
quetiapine showed both the features associated with antipsychotic
efficacy and a low rate of motor effects (Goldstein 1999; Nemeroff et al. 2002). The Phase III placebo-controlled clinical trials
necessary for product registration confirmed this preclinical impression and
demonstrated that quetiapine was efficacious in treating the manifestations
of psychosis (Arvanitis and Miller 1997; Small et al. 1997). Of note, these studies also reported a low
rate of treatment-emergent extrapyramidal side effects (EPS) with
quetiapine use across a wide range of dosages that was comparable
to the rate among placebo recipients. Quetiapine was approved in
1997 by the U.S. Food and Drug Administration (FDA) for the treatment
of schizophrenia. Approval for use in Europe and in other countries
worldwide has followed. Further clinical trials in patients with
mania (McIntyre et al. 2005; Vieta et al. 2005)
and patients with bipolar depression (Calabrese et al. 2005; Thase et al. 2006) led the FDA to approve additional indications
for quetiapine's use in the acute and maintenance treatment
of bipolar disorder. Most recently, the FDA has also approved a
slow-release formulation of quetiapine for the treatment of schizophrenia
(Kahn et al. 2007; Möller et al. 2007; Peuskens et al. 2007). Quetiapine is an established antipsychotic
with broad efficacy and good tolerability, particularly with respect
to EPS (Miodownik and Lerner 2006).