Læknablaðið : fylgirit - 01.08.2003, Page 78

■ POSTERS / 27TH NORDIC PSYCHIATRIC CONGRESS
that Olanzapine should be further explored as a potential alternative
to conventional neuroleptic medication for treatment of tics in TD.
Note:
• Two (subtitled) videos (recorded week 1 of treatment and week 2 of treatment)
can be shown to illustrate improvement
• Written, informed consent was obtained from the patient before presentation of
this case.
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Quetiapine monotherapy for the treatment of mania
M Brecher, AstraZeneca, Wilmington, Delaware, USA. K Huizar, AstraZeneca,
Södertalje, Sweden
martin.brecher@astrazeneca.com
Background: First-line therapy options for the treatment of mania
include monotherapy with a mood stabilizer or atypical antipsy-
chotic.
Aims: To evaluate quetiapine as monotherapy for mania.
Method: Patients (bipolar I disorder, manic episode) were rando-
mized to 12 weeks double-blind treatment with quetiapine (QTP)
(up to 800 mg/d), placebo (PBO), or an internal standard (haloperi-
dol [HAL]). The primary endpoint was change from baseline
YMRS score at Day 21 (QTP vs PBO).
Kcsults:53.9% (55/102) ofQTP- vs41.6% (42/101) ofPBO-lreated
patients completed. Quetiapine-treated patients had a significant
improvement in YMRS score vs PBO at Day 21 (-12.29 vs -8.32;
P=0.0096), that increased by Day 84 (P<0.0001). Significantly more
QTP patients achieved a YMRS response (>50% decrease) at Day
84 (QTP 61.4%; PBO 39.0%; P=0.0015). Significant improvements
in YMRS score at Days 21 and 84 for HAL were also observed.
EPS were consistently higher in the HAL group (any EPS event:
HAL 59.6%; QTP 12.7%; PBO 15.8%), as were discontinuations
due to adverse events (HAL 10.1%; QTP4.9%; PBO 5.9%). Mean
last-week QTP dose in responders at Day 21 was 559 mg/d.
Conclusions: Quetiapine monotherapy is well tolerated and signifi-
cantly more effective than placebo in the treatment of mania.
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Randomized, double-blind, controlled data on the
treatment of mania with Quetiapine
Martin Jones, Director, Biostalistics, Astra Zeneca, 1800 Concord Pike, P.O. Box
15437, Wilmington, DE 15437, USA. Karin Huizar.
martin.jones@astrazeneca. com
Background: Treatment guidelines for acute mania include mono-
therapy wilh lilhium or an antipsychotic.
Aims: Evaluate the atypical antipsychotic quetiapine for the treat-
ment of mania.
Mcthod: Patients (N=604) with bipolar mania were treated with
quetiapine (up to 800 mg/d), placebo, or an internal control (lithium
or haloperidol) for 84 days. Outcomes were compared on several
efficacy and safety endpoints.
Rcsults: 60.8% (127/209) of quetiapine-treated vs 38.9% (77/198) of
placebo-treated patients completed. The mean last-week quetia-
78 LÆKNABLAÐIÐ / FYLGIRIT 48 2003/89
pine dose in responders at Day 21 was 575.5 mg/d. A significant
improvement on the YMRS was observed with quetiapine by as
early as Day 4 (P=0.021) that remained significant to Day 84
(P<0.001). At the primary endpoint (Day 21) improvement on the
YMRS was -13.58 for quetiapine vs -7.76 for placebo (P<0.0001).
Patients improved significantly in the lithium and haloperidol
groups. Common adverse events (>10%) in the quetiapine group
were somnolence, dry mouth, and insomnia (insomnia was repor-
ted at a similar rate in all groups). Tremor was common in the halo-
peridol and lithium groups. Akathisia and extrapyramidal synd-
rome were common in the haloperidol group.
Condusion: Quetiapine monotherapy is effective, fast-acting, and
well tolerated when used for the treatment of mania associated with
bipolar disorder.
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Escitalopram and paroxetine in fixed doses for the
treatment of social anxiety disorder (SAD)
EH Reincsi, Section Hcad, H. Lundbeck A/S, Ottiliavej 9, 2500 Valby-Copenhagen,
Denmark. SA Montgomcry2, M LaderL R Nil4.
ER@lundbeck. com
1H. Lundbeck A/S, Copenhagcn, Denmark; -Imperial College School of Mcdicine,
London, United Kingdom; 3Institute of Psychiatry, University of London, London,
UK; 4Lundbeck (Switzerland) Ltd., Glattbrugg, Switzerland
Social anxiety disorder (SAD) is one of the most common psychi-
atric disorders, but it remains under-treated because patients feel
unable to seek help. However, SAD can be treated and failure to
commence treatment has serious social and medical consequences.
A randomised, double-blind study in patients with SAD was
conducted. After a 1-week, single-blind, placebo run-in period,
patients were randomised to 24 weeks of double-blind treatment
with fixed doses of escitalopram [5mg/day (n=167), lOmg/day
(n=168), or 20mg/day (n=170)], paroxetine [20mg/day (n=169)], or
placebo (n=166). Patients who completed double-blind treatment
entered a 2-week, single-blind, placebo run-out period.
Escitalopram demonstrated significant efficacy relative to place-
bo for the primary endpoint (change from baseline to Week 12
(LOCF) in LSAS total score) for 5 and 20mg (p<0.001) and a clear
trend for lOmg (p=0.059). A further improvement in change from
baseline in LSAS total score was seen for all doses at Week 24
(OC), with significant superiority over placebo for 5 (-8.1; p=0.006),
10 (-7.5; p=0.013), and 20mg (-17.35; p<0.001) escitalopram and for
paroxetine, (-9.6; p=0.001). On the basis of this analysis, 20mg
escitalopram was also significantly superior to the other escitalopram
doses and 20mg paroxetine (-7.7; p=0.008;OC). Escitalopram was
well tolerated. Tlie proportion of withdrawals due to AEs was low
and was higher in the paroxetine group than in the escitalopram or
placebo groups. Significantly fewer discontinuation effects were
seen for all escitalopram doses on the DESS than for paroxetine.
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Abstract withdrawn
j