Seroquel: Treatment for alcoholism : Wayne MacFadden, AstraZeneca funded study

A Double-Blind, Placebo-Controlled Pilot Trial of Quetiapine for the Treatment of Type A and Type B Alcoholism-- June 2006, revised April 2007

Kampman, Kyle M. MD*; Pettinati, Helen M. PhD*; Lynch, Kevin G. PhD*; Whittingham, Tom BS*; Macfadden, Wayne MD†; Dackis, Charles MD*; Tirado, Carlos MD*; Oslin, David W. MD*; Sparkman, Thorne MD‡; O'Brien, Charles P. MD, PhD*

*Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA; †Ortho-McNeil Janssen Scientific Affairs, Titusville, NJ and ‡Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.

Received June 29, 2006; accepted after revision April 9, 2007.

This trial was supported by a grant from AstraZeneca Pharmaceuticals.

Dr.Wayne Macfadden was the US Medical Director for Seroquel at the time this trial was conducted.

Abstract

Background: Atypical antipsychotics may be useful in the treatment of alcohol dependence.

Human trials suggest that atypical antipsychotics may reduce alcohol craving and consumption, especially among patients with comorbid psychopathology.

Therefore, these medications may be more useful for treating more severely affected alcoholics, such as patients with Type B alcoholism.

Type B alcoholics are characterized by an early age of onset of problem drinking, high severity of alcohol dependence, increased psychopathology, and treatment-resistance.

Quetiapine (Seroquel) is an atypical antipsychotic with a favorable side effect profile, and may be a promising medication for the treatment of alcohol dependence, particularly Type B alcoholism.

[favorable side effect profile? diabetes? weight gain? lawsuit in federal court regarding internal documents withholding truthful data?]

Methods: Male and female alcoholics (33 Type A and 28 Type B) were included in a 12-week, double-blind, placebo-controlled trial. After detoxification, patients were randomized to receive quetiapine (n = 29), 400 mg/d at bedtime, or placebo (n = 32). The primary outcome measure was the quantity and frequency of alcohol consumption, measured by the timeline follow back.

Results: Forty-seven patients (77%) completed the trial, with no significant between-group differences in treatment retention. Nine quetiapine-treated patients (31%) maintained complete abstinence compared with 2 placebo-treated patients (6%) (χ2 = 6.3, P = 0.012). There was a significant interaction between quetiapine and alcoholic subtype. As predicted, quetiapine- versus placebo-treated Type B alcoholics had significantly fewer days of drinking and fewer days of heavy drinking. Alcohol craving was also significantly reduced in quetiapine-treated compared with placebo-treated Type B alcoholics. Among Type A alcoholics, quetiapine provided no advantage over placebo in improving drinking outcomes.

Conclusions: Quetiapine may be effective for the treatment of alcohol dependence, particularly in the more complicated Type B, early-onset alcoholics.
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Participants were given 400mg. of Seroquel at bedtime, and therefore apparently reduced alcohol consumption. I completely disagree with the statement in this study that Seroquel has a favorable side effect profile. It's being abused (snorted) in prisons and has street drug sale value.

The fact that this was a AstraZeneca (maker of Seroquel)funded study, with Wayne MacFadden in place as the AstraZeneca medical director at the time is an enormous conflict of interest, and in my opinion with AstraZeneca's current lawsuits in federal court any study's outcome funded by the company should be held as questionable results for profit of drug sales.