Past Research and Cognitions of Quetiapine Use in the Treatment of Alcohol Dependence
Vukic, Vivian, Karlovic, Dalibor, Buljan, Danijel, Alcoholism
Quetiapine is an atypical antipsychotic or a second-generation antipsychotic. It has been used in the treatment of positive and negative symptoms of schizophrenia, depressive episodes of bipolar disorder, acute manic episodes connected with bipolar disorder and as a therapy for maintaining bipolar disorder. It has also been used in the treatment of obsessive-compulsive disorder, PTSD, Tourette syndrome, alcoholism and it is prescribed as a sedative in patients with anxious disorder and troubles with sleeping. Some studies have shown that the use of antipsychotics in alcoholics decreases alcohol intake and craving and alleviates psychiatric symptoms in addicts and patients who, besides alcoholism, suffer also from other psychiatric diseases such as schizophrenia, bipolar disorder and borderline personality disorder. It has been proven that Quetiapine is successful in the treatment of type B alcoholism, then in alcoholics suffering from anxiety, sleep disorder and who have symptoms of depression. This paper shows past cognitions of the use of Quetiapine in the treatment of alcohol dependence.
Keywords : quetiapine; alcohol dependence; pharmacotherapy
Alcoholism is the most frequent addiction disease. It has appeared in all social and economic groups, in each age group and in both women and men. Research has shown that in countries such as Croatia, USAand England around 15% of women and 25% of men drank alcohol excessively, and alcoholism was diagnosed in 3-5% of women and 10% of men.1 The number of women dependent on alcohol is constantly increasing. In the last few years the ratio of men and women in Croatia has been 3.6:1. The monitoring of drinking habits among young persons from 1995 to 2005 has also shown an increase in drinking among adolescents. When it comes to the share of children who had drunk in the previous year, Croatia was below the European average thirteen years ago (the average was 80%, in Croatia 70%). However, in 2007 Croatia was above the European average (82%, Croatia 84%). 2 This fact is very disturbing since early use of alcohol carries the risk of adopting alcohol drinking as a habit, and those who started drinking earlier have higher chances to become alcoholics as the time passes. Around 30-45% of persons older than 18 have had at least once in their life a problem related to alcohol use, e.g. alcohol amnesia, difficulties at school or at the workplace, or traffic violations. The prevalence of drinking is highest between 21and 34 years of age. In the group of mental disorders and behavior disorders, mental disorders induced by alcohol accounted for 21.4% of all hospitalizations in working population (20-59 years of age) in 2009. 3 Sixty percent of all traffic accidents was caused by alcohol abuse. More than 50% of homicides and 25% of all suicides have been caused by alcohol. In the USA alcohol abuse causes around 100 000 deaths per annum. 4 Alcoholism represents a big public health problem which costs the USA around 185 billion dollars annually.5
A review of pharmacotherapy used in the treatment of alcoholism
Medicines which decrease the desire for alcohol are naltrexon and acamprosate.
Naltrexon is an opioid receptor antagonist which blocks the pleasure of drinking and makes the abstinence possible by cutting the reward cycle. Naltrexon has an aversive activity too, so if alcohol is taken after it, nausea and weakness can occur strengthening the alcohol intoxication. 2 There is also a depot preparation of this drug (Vivitrol), in the dosage of 380 mg, which is injected intramuscularly once a month. If we take into consideration past studies on Naltrexon, some are in favor of Naltrexon intake, while others stress the fact that there is no statistically significant difference between Naltrexon and the placebo.6
Acamprosate (Campral) is used in the treatment of alcoholism combined with other therapeutic programs. It is a derivate of taurine amino acid. …