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Treatment of methamphetamine-induced psychosis: a double-blind randomized controlled trial comparing haloperidol and quetiapine

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Abstract

Rationale

To our knowledge, only a few double-blind randomized controlled trials with antipsychotic drugs have been conducted to examine the treatment of methamphetamine-induced psychosis (MAP).

Objectives

The aims of this study are to compare the antipsychotic and adverse events of quetiapine, an atypical antipsychotic drug, to haloperidol, a standard treatment for primary psychotic disorder, in individuals with MAP.

Methods

Eighty individuals with MAP were randomly assigned into two groups, i.e. treatment with quetiapine (n = 36) and haloperidol (n = 44). Sixty-eight patients (85 %) completed the study protocol, i.e. treatment with quetiapine at least 100 mg per day or haloperidol at least 2 mg per day orally once a day for 4 weeks. The doses were increased every 5 days until no psychotic symptom was observed from the Positive and Negative Syndrome Scale (PANSS). Data were analysed by survival analysis with Cox’s proportional regression analysis, general estimating equations and log-rank tests.

Results

Thirty-two (89 %) subjects from the quetiapine group and 37 subjects (84 %) from the haloperidol group met the remission criteria at the end of the study. Baseline PANSS total scores of quetiapine and haloperidol groups were 82.4 ± 16.6 and 90.0 ± 18.4, respectively (mean ± SD; p = 0.06). The change-from-baseline scores were −47.8 for the quetiapine group and −53.2 for the haloperidol group. There were no significant differences between the antipsychotic effects (coefficient value = −2.6, p = 0.32, 95%CI = −7.6, 2.5) and the adverse effects of quetiapine and haloperidol.

Conclusions

Quetiapine may be used as an antipsychotic treatment for MAP with comparable therapeutic effects and adverse events to treatment with classical antipsychotic drugs.

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Acknowledgments

This study was funded by the National Research Council of Thailand (NRCT). RK is supported for conducting research by the mid-career researcher grant (RMU5380025) co-funded by the Thailand Research Fund (TRF), the Office of the Higher Education Commission of Thailand, Chulalongkorn University and the Faculty of Medicine, Chulalongkorn University and the D43 TW006166. The experiments comply with the current Thai laws.

Conflict of interest

None of the authors have had a financial relationship with the organization that sponsored the research. The study is not supported by, nor any income received, from a commercial sponsor.

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Correspondence to Rasmon Kalayasiri.

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Verachai, V., Rukngan, W., Chawanakrasaesin, K. et al. Treatment of methamphetamine-induced psychosis: a double-blind randomized controlled trial comparing haloperidol and quetiapine. Psychopharmacology 231, 3099–3108 (2014). https://doi.org/10.1007/s00213-014-3485-6

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  • DOI: https://doi.org/10.1007/s00213-014-3485-6

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