Restless Legs Syndrome in an Elderly Patient Induced by Combined Use of Low Dose Quetiapine and Citalopram

basterzi, ayse/0000-0003-4813-4377WOS: 000311598000010Restless legs syndrome in an elderly patient induced by combined use of low dose quetiapine and citaloprann Restless legs syndrome (RLS) is a relatively common sensory-motor disorder. However, it is frequently unrecognized. The main clinical characteristics of RLS are "an urge to move" and "uncomfortable and unpleasant sensations" in the legs, which can affect quality of daily life and sleep. The diagnosis is based on clinical findings. Polysomnography can reveal its impact on sleep physiology. Dopaminergic dysfunction and a change in the regulation of iron homeostasis leading to iron depletion in the central nervous system (CNS) are thought to be involved in the pathophysiology of RLS. The aim of this paper is to point out the side effects with off-label use of antipsychotics and call attention to often overlooked RLS by describing an elderly patient who developed RLS symptoms after addition of 50 mg/d quetiapine to preexisting 20 mg/d citalopram treatment

Quetiapine fumarate augmentation for patients with a primary anxiety disorder or a mood disorder: a pilot study

<p>Abstract</p> <p>Background</p> <p>Comorbid anxiety symptoms,in patients with a primary anxiety disorder or a mood disorder, leads to poor patient outcomes and burdens the healthcare system. This pilot study evaluated the feasibility of extended-release quetiapine fumarate (quetiapine XR) for the treatment of patients with either a primary anxiety disorder or a mood disorder with comorbid anxiety symptoms compared to a placebo, as an adjunct to antidepressant therapy.</p> <p>Methods</p> <p>Thirty-nine patients with a diagnosis of a primary anxiety disorder or a mood disorder with comorbid anxiety symptoms were enrolled in this study. Patients with a stable dose of antidepressant therapy were randomized according to a 2:1 probability of receiving either quetiapine XR or a placebo adjunctive treatment for 8 weeks. The efficacy was assessed by the Hamilton Anxiety Rating Scale (HAM-A) and the Clinical Global Impression of severity (CGI-S) score at baseline, week 1, 4, and 8.</p> <p>Results</p> <p>A total of 35 patients were included in this intention-to treat (ITT) population for the efficacy analysis (quetiapine XR: 22 patients; placebo: 13 patients). At week 4, statistically significant differences were observed on both the HAM-A score (p = 0.003) and the CGI-S score (p = 0.025), favouring the quetiapine XR (−13.00 ± 4.14) compared to placebo (−6.63 ± 5.42). However, no statistically significant difference was observed between the two groups with regard to changes from the baseline to week 8 on the HAM-A score (p = 0.332) or the CGI-S score (p = 0.833).</p> <p>Conclusions</p> <p>Augmentation of antidepressant treatment with quetiapine XR did not result in clinical improvement according to the outcome measure of anxiety using the HAM-A and CGI-S scores at week 8, among the patients with either a primary anxiety disorder or a mood disorder with comorbid anxiety symptoms. However, treatment with quetiapine XR as an adjunct to antidepressant therapy appeared to provide a short-term benefit at 4 weeks. Further study is needed with a larger sample size, randomized controlled design and control of the dosage prescribed.</p> <p>Trial registration</p> <p>Clinicaltrials.gov identifier: NCT00912535</p