An open label study of quetiapine in patients with schizophrenia and alcohol disorders

Background: Preliminary studies suggest that quetiapine, a mixed dopaminergic and serotonergic agent used for the treatment of psychosis, may decrease substance use in patients with schizophrenia. Method: A three-month, uncontrolled, open-label prospective study of 23 outpatients with schizophrenia or schizoaffective disorder and co-occurring alcohol use disorder was conducted at two sites. Due to substantial site differences, outcomes are reported separately for each site on the 16 study subjects who completed at least one month of quetiapine treatment (mean dose 472 ± 255mg). Results: At Site 1 (n=11), mean days of drinking each week decreased, but not significantly (3.18 ± 1.63 to 2.71 ± 2.32, t=1.2, df=10, p=.26). At Site 2 (n=5), mean days of drinking dropped from 3.1 ± 1.19 to 0.24 ± 0.17 (t=5.0, df=4, p=0.007). At that site, patients were younger, had fewer prior hospitalizations, and the majority (83.3%) were recently in a psychiatric inpatient unit. Conclusion: Quetiapine may have a positive impact on alcohol use in patients with co-occurring schizophrenia/schizoaffective disorder and alcohol use disorder. Randomized, controlled trials are needed to clarify whether quetiapine has a specific effect on alcohol use in patients with such co-occurring disorders.