Quetiapine in the treatment of psychotic adolescents

Objective: The treatment of psychotic adolescents with quetiapine (QUE) in a clinic for child and adolescent psychiatry was evaluated retrospectively.

Methods: 26 adolescents (13–17 years) with a diagnosis of a psychotic disorder (F20: N=21; F23: N=2; F25: N=3) were treated with QUE while being hospitalized. All patients were admitted to an acute unit of the clinic and transferred to an open unit after stabilization. Clinical efficacy was measured by Clinical Global Impressions (CGI)-Severity of Illness. Safety and tolerability were controlled for regularly.

Results: During the observation period of 3.5±1.7 months, CGI-Severity of Illness score improved (baseline: 5.42±0.95; endpoint: 3.04±0.96; p<0.001). At discharge, 24 patients were receiving QUE (21 monotherapy). The final average treatment dose was 681±262mg (range 400–1200mg). Plasma levels were 100±65 ng/ml (N=16; dosis: 875±240mg). The average (uncorrected) weight gain was 5.6±5.3kg. Sedation, vertigo, moderate tachycardia, obstipation and xerostomia were observed sporadically; mild EPS were seen in one patient under QUE monotherapy. In none of the patients, pathological ECG changes occurred. In 16 patients, transaminases raised temporarily (in 3 patients more than threefold above norm). In 47% of the cases, T4 values were slightly below the norm.

Conclusion: QUE appears to be an effective treatment for adolescents with a severe psychotic disorder, showing a favourable side-effect profile even for higher doses.