quetiapine-fumarate and Autistic-Disorder

Atypical antipsychotics are emerging as the first-line pharmacologic treatment for irritability (i.e., aggression, self-injurious behavior, and severe tantrums) in children and adolescents with autistic and other pervasive developmental disorders. Results from placebo-controlled and open-label studies of clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole in this subject population are reviewed. Additional placebo-controlled trials and studies of longer-term safety and tolerability are needed.

Topics: Adolescent; Aggression; Antipsychotic Agents; Aripiprazole; Autistic Disorder; Benzodiazepines; Child; Child Development Disorders, Pervasive; Child, Preschool; Clozapine; Dibenzothiazepines; Disorders of Excessive Somnolence; Humans; Obesity; Olanzapine; Piperazines; Quetiapine Fumarate; Quinolones; Risperidone; Thiazoles

The atypical antipsychotic quetiapine has been examined in children and adolescents in a randomized clinical trial, a number of open-label studies, and several chart review studies. Although only a small amount of information exists, most studies indicate that quetiapine is effective and well tolerated in various pediatric populations. Because quetiapine appears to be well tolerated in the young and associated with manifest salutary effects, it seems to be a promising agent that has potential for use in children and adolescents. This article reviews studies of quetiapine in the treatment of children and adolescents with a variety of psychiatric disorders. Despite these encouraging findings, the number of studies is small, and some have methodological limitations. Methodologically rigorous studies with substantive numbers of subjects are needed to confirm or refute these preliminary impressions.

Topics: Adolescent; Age Factors; Antipsychotic Agents; Autistic Disorder; Basal Ganglia Diseases; Child; Clinical Trials as Topic; Dibenzothiazepines; Humans; Medical Records; Psychotic Disorders; Quetiapine Fumarate; Retrospective Studies; Treatment Outcome

Bipolar disorder (BD) has been linked with the manifestation of catatonia in subjects with autism spectrum disorders (ASD). Idiopathic basal ganglia calcification (IBGC) is characterized by movement disorders and various neuropsychiatric disturbances including mood disorder.. We present a patient with ASD and IBGC who developed catatonia presenting with prominent dystonic feature caused by comorbid BD, which was treated effectively with quetiapine.. In addition to considering the possibility of neurodegenerative disease, careful psychiatric interventions are important to avoid overlooking treatable catatonia associated with BD in cases of ASD presenting with both prominent dystonic features and apparent fluctuation of the mood state.

Topics: Adolescent; Autistic Disorder; Basal Ganglia; Bipolar Disorder; Brain Diseases; Calcinosis; Catatonia; Diagnosis, Differential; Dibenzothiazepines; Humans; Magnetic Resonance Imaging; Male; Quetiapine Fumarate; Tomography, X-Ray Computed

Topics: Adolescent; Autistic Disorder; Bipolar Disorder; Contraceptives, Oral, Combined; Dibenzothiazepines; Female; Humans; Menstrual Cycle; Mood Disorders; Quetiapine Fumarate

The aim of this study was to examine the effectiveness of quetiapine in adolescents suffering from autistic disorder (AD).. This was a 12-week, open-label study, for which medically healthy patients with AD between the ages of 10 and 17 years were eligible. Quetiapine treatment was gradually increased over the first 6 weeks of the study, to a total daily dose of 300 mg/day. Doses could then be increased to a maximum daily dose of 750 mg/day. Outcome measures included the Children's Psychiatric Rating Scale (CPRS) and the Clinical Global Impressions (CGI) scale.. Nine (9) males were enrolled. Six (6) patients had previously been treated with other psychotropic agents. Although improvements in several symptom domains were observed on quetiapine, only 2 patients met a priori criteria for response ("much" or "very much improved" on the Clinical Global Impressions-Improvement Scale). In addition, only these same 2 patients' parents/guardians chose to continue quetiapine pharmacotherapy after study participation.. These data suggest that quetiapine may not be a particularly effective agent in the treatment of adolescent patients with AD. However, should future studies be performed, it seems reasonable that they be conducted with more rigor, less treatment-resistant cohorts, and, possibly, a different dosing strategy.

Topics: Adolescent; Antipsychotic Agents; Autistic Disorder; Behavior; Child; Dibenzothiazepines; Dose-Response Relationship, Drug; Female; Humans; Male; Psychiatric Status Rating Scales; Psychometrics; Quetiapine Fumarate; Treatment Outcome

The purpose of this trial was to investigate the short-term safety and efficacy of quetiapine fumarate in the treatment of children and adolescents with autistic disorder (AD).. This was a 16-week, open-label trial that included 6 male subjects with a mean age of 10.9 +/- 3.3 years. All subjects met the DSM-IV criteria for AD and functioned in the mentally retarded range (mild, n = 2; moderate, n = 3; severe, n = 1). Behavioral ratings were obtained at baseline and every four weeks thereafter.. Overall, there was no statistically significant improvement between baseline and endpoint for the group as a whole. Only two subjects completed 16 weeks of treatment and were considered "responders" by the global improvement item of the Clinical Global Impression Scale (CGIS). Dosages ranged from 100 to 350 mg/day (1.6-5.2 mg/kg/day). Subjects dropped out prematurely because of lack of response and sedation, limiting further dose increases (n = 3), and because of a possible seizure during the fourth week of treatment (n = 1). Other significant side effects included behavioral activation, increased appetite and weight gain (range, 0.9 to 8.2 kg).. Quetiapine was poorly tolerated and associated with serious side effects in this clinical population.

Topics: Adolescent; Antipsychotic Agents; Autistic Disorder; Child; Dibenzothiazepines; Humans; Male; Prospective Studies; Quetiapine Fumarate; Weight Gain