quetiapine-fumarate and Brain-Injuries

In a 6-week open-label, flexible dose pilot study of quetiapine for treatment of aggression secondary to traumatic brain injury (TBI), seven subjects who were at least 3-months post-injury were enrolled. The Overt Aggression Scale - Modified (OAS-M) and Clinical Global Impression (CGI) were primary outcome measures. Administration of quetiapine at doses of 25 to 300 mg daily was efficacious and well-tolerated in reducing irritability and aggression resulting from TBI, with an associated improvement in cognitive functioning.

Topics: Aggression; Antipsychotic Agents; Brain Injuries; Cognition; Dibenzothiazepines; Female; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Pilot Projects; Quetiapine Fumarate

To investigate whether the incidence of neutropenia was higher in subjects who received a combination treatment with valproate and quetiapine than in those who were administered monotherapy.. Retrospective cohort study.. Rehabilitation department of a university hospital.. Patients with acquired brain injuries who had taken valproate for seizures or quetiapine for delirium for >7 days (N=101). Data were extracted from electronic medical records of the hospital.. Not applicable.. Incidence of neutropenia (absolute neutrophil count<2000 cells/μL) was elicited from the weekly complete blood cell records for 71.07±43.71 days of observation. The odds ratio for neutropenia development was calculated and adjusted for variables that showed significant differences between patients with or without neutropenia.. The incidence of neutropenia was significantly higher in the group receiving the combination treatment than in those receiving the monotherapy (32.26% vs 12.90%, adjusted P=.036), despite a lack of any differences in the daily doses of the medications. Coadministration of quetiapine and valproate was the predictor of neutropenia development when age, body weight, and underlying diseases were adjusted in the logistic regression model (odds ratio=3.749; 95% confidence interval, 1.161-12.099; P=.027).. Administration of quetiapine together with valproate in patients with acquired brain injury could increase the incidence of medication-induced neutropenia.

Topics: Aged; Anticonvulsants; Antipsychotic Agents; Brain Injuries; Cohort Studies; Delirium; Drug Therapy, Combination; Female; Humans; Incidence; Male; Middle Aged; Neutropenia; Quetiapine Fumarate; Retrospective Studies; Valproic Acid

Early treatment of epilepsy is warranted to avoid possible severe consequences. This study aimed to assess the value of treatment in a patient who developed epilepsy after major brain surgery.. Case description. A 51 years-old man had a history of putative petit mal seizures since adolescence and left frontotemporal lobectomy after a major traffic accident at age 17. He subsequently developed quickly generalizing partial complex seizures, associated with severe behavioural alterations and personality changes; the condition was left untreated. A further seizure-related loss of consciousness led to another traffic accident at age 47.. The patient was administered 200 mg/day topiramate, 600 mg/day quetiapine, 1000 mg/day valproate, 1200 mg/day gabapentin and 800 mg/day carbamazepine.. The instituted anti-epileptic treatment reduced seizure frequency and severity, but did not affect psychiatric symptomatology, which even worsened. An association between anti-epileptic drugs with mood stabilizing properties and an atypical anti-psychotic dramatically improved psychiatric symptoms, but did not prevent the patient from needing long-term healthcare.. Long-term untreated epilepsy may expose to accident proneness and further psychiatric deterioration. Early diagnosis and treatment of epilepsy may help in avoiding a potentially lethal vicious circle.

Topics: Accidents, Traffic; Aggression; Amines; Anterior Temporal Lobectomy; Anticonvulsants; Brain Injuries; Carbamazepine; Cyclohexanecarboxylic Acids; Dibenzothiazepines; Disease Progression; Early Diagnosis; Epilepsy; Fructose; Gabapentin; gamma-Aminobutyric Acid; Humans; Italy; Male; Middle Aged; Personality Disorders; Quetiapine Fumarate; Time Factors; Topiramate; Treatment Outcome; Valproic Acid

Topics: Adult; Antipsychotic Agents; Brain Injuries; Dibenzothiazepines; Dose-Response Relationship, Drug; Humans; Male; Psychotic Disorders; Quetiapine Fumarate

Topics: Adult; Antimanic Agents; Antipsychotic Agents; Behavior Control; Brain Injuries; Dibenzothiazepines; Humans; Male; Psychomotor Agitation; Quetiapine Fumarate; Rehabilitation Centers; Selective Serotonin Reuptake Inhibitors; Sleep Disorders, Intrinsic; Trazodone; Valproic Acid

Topics: Adult; Antipsychotic Agents; Bipolar Disorder; Brain Injuries; Citalopram; Dibenzothiazepines; Drug Administration Schedule; Humans; Male; Quetiapine Fumarate

Secondary mania develops in as many as 9% of persons with traumatic brain injuries. The treatment of posttraumatic mania is not well defined, and agents traditionally used for the treatment of idiopathic manic episodes may not be well suited for use among individuals with traumatic brain injuries. Atypical antipsychotics are indicated for the treatment of idiopathic bipolar disorder, and have been used for other purposes among individuals with posttraumatic neuropsychiatric disturbances. This article offers the first description of the treatment of posttraumatic mania using the atypical antipsychotic quetiapine. Beneficial effects of this agent on posttraumatic mania, cognitive impairments, and functional disability in the subacute post-injury period are described. Possible mechanisms of action are discussed and the need for additional investigation of quetiapine for posttraumatic mania is highlighted.

Topics: Accidents, Traffic; Adult; Antipsychotic Agents; Bipolar Disorder; Brain; Brain Injuries; Dibenzothiazepines; Humans; Male; Quetiapine Fumarate; Tomography, X-Ray Computed

Weight gain in mentally ill patients is an evident problem, and obesity can be two- to three-fold more prevalent in psychiatric patients than in the general population. We report two patients who gained weight during previous antipsychotic treatment but who lost weight when shifted to quetiapine.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Brain Injuries; Chlorpromazine; Dibenzothiazepines; Humans; Male; Obesity; Olanzapine; Quetiapine Fumarate; Schizophrenia, Paranoid; Weight Gain; Weight Loss