Non-interventional epidemiological program for investigating the real-life practice of using quetiapine (Seroquel®) in patients with schizophrenia and bipolar affective disorder (EPIDEMICUS)

Abstract

The polymorphism of the clinical manifestations of schizophrenia and bipolar affective disorder (BD), late referral to the doctor, comorbidity with somatic diseases and the use of somatotropic medications by psychiatric patients, as well as the frequent development of adverse events (AEs), require constant analysis and improvement of the methods and means of psychopharmacotherapy.Objective: to study the characteristics of the use of quetiapine (Seroquel®) in real outpatient clinical practice.Material and methods. A patient was enrolled in the program if there was a need to prescribe quetiapine (Seroquel®) or to switch from the current therapy to quetiapine. During the program visit, the doctor filled in an individual registration card with information about patient and therapy. The data were statistically analyzed.Results. Quetiapine is prescribed by practicing psychiatrists in Russia not only according to the official indications, but also for psychopathological disorders of other nosology with similar clinical manifestations, such as dementia, organic and affective (depressive episode, recurrent depressive disorder), as well as psychogenic disorders. Up to 27.3% of physicians consider the effect of quetiapine to be quite sufficient in a mixed affective state within the framework of BD dynamics. Quetiapine is used by physicians to treat patients with varying duration of mental disorder (mean 5.1–13.5 years), severity of current mental state (mean CGI-S score 4.3–4.97) and a wide age range (mean age 34.5–60.8 years). When prescribing quetiapine, physicians note that the drug has antidepressant, anxiolytic, sedative and hypnotic effects, regardless of the type of mental disorder. Quetiapine is mainly prescribed as a monotherapy, either primary or resumed after a break – 815 (64.5%) observations. At the same time, quetiapine is used significantly more frequently as monotherapy for BD (69.4%) and mental illnesses of other origin (64.7%) than for schizophrenia (53.8%; p <0.005).Conclusion. In real clinical practice, quetiapine is perceived by psychiatrists as a highly effective and well-tolerated antipsychotic with a broad spectrum of activity that goes beyond the official indications. The practical experience of physicians in Russia shows that in addition to sedative, antipsychotic, antimanic and antidepressant effects, the drug also has antinegative, procognitive, anxiolytic, antiresistant and mood-stabilizing properties.