Dissertation
Dissertation > Medicine, health > Neurology and psychiatry > Psychiatry > Mental disorders of toxic > Alcohol disorder

The Impact of Quetiapine on Protracted Withdrawal Symptoms and Brain Electrophysiology of Inpatients with Alcohol Dependent

Author WangZhiJian
Tutor ZhangRuiLing
School Xinxiang Medical
Course Psychiatry and Mental Health
Keywords Quetiapine alcohol dependence protracted withdrawal symptoms polysomnography Event-related potentials exploratory eye movement
CLC R749.62
Type Master's thesis
Year 2013
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BackgroundLong-term quantities drinking can cause severe physical injure and psychiatrical nerve injure and social loss. Psychological nerve injure include alcohol dependence, related psychiatrical disorders and cognitive function disorders. Now Alcohol dependence has become a international common health problem and heavily impacted individual health and family happiness and social stability. The relapse rate one year after withdrawal from Alcohol dependence reached up to fifty percent and it may correlated with protracted withdrawal symptoms such as anxiety, depression, insomnia. Although Disulfiram, naltrexone and acamprosate which were approved by FDA have some effect in treating alcohol dependence, they had some shortcoming in clinical global evaluation and it became clinical significance to search new drug in treating alcohol dependence. Some animal research indicated that quetiapine could effectively alleviate alcohol withdrawal sign and had nerve prevention effect, clinical study demonstrate that quetiapine could improve sleep disorder of alcohol dependence, increase the days of keeping from alcohol and reduce hospital days. This study evaluated treatment effect of quetiapine on protracted withdrawal symptoms and brain electrophysiology of inpatients with alcohol dependent.Objectives1. Assess the treatment effect of quetiapine on protracted withdrawal symptoms of inpatients with alcohol dependence.2. Explore the impact of quetiapine on sleep quality and sleep structure of inpatients with alcohol dependence after acute withdrawal.3. Explore the impact of quetiapine on event-related potentials(ERPs) and exploratory eye movement (EEM) of inpatients with alcohol dependence after acute withdrawal.Methods1. According to inclusion criteria, patients with alcohol dependence hospitalized between January in2012to January in2013were selected and were randomly divided into quetiapine treatment group (quetiapine group) and vitamins treatment group (control group). All patients were treated with benzodiazepine class of drugs and vitamins in acute withdrawal phase for one week. Setting weekend for the study baseline period, starting from the baseline, patients in quetiapine group were given variable doses of quetiapine (300to400mg/d) treatment and control group continued vitamin therapy. The treatment period was four weeks. If the patient was discharged early, out-patient would be reviewed2. Patients in quetiapine group and control group were evaluated with Pennsylvania Alcohol Craving Scale (PACS), visual analog craving scale (VAS), Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA) and the Pittsburgh sleep Quality Index (PSQI) respectively at baseline and quetiapine treatment4weekend to assess the effect of quetiapine treatment of protracted withdrawal symptoms.3. Patients in quetiapine group and control group were detected with polysomnography (PSG) respectively at baseline and quetiapine treatment for4weeks to know the effect of quetiapine on sleep architecture and sleep quality of alcohol dependence withdrawal.4. Patients in quetiapine group and control group were accepted ERP-P300and EEM detection respectively at baseline and quetiapine treatment for4weeks in order to understand the effects of quetiapine in patients with alcohol dependence withdrawal of P300and exploratory eye movement analysis.5. All dates were analyzed with SPSS16.0statistical software and numeration data was analyzed with chi square analyses and measurement date was expressed with mean and standard deviation. Pair t test was used between before treatment and after treatment in group and independent t test between groups. Results1. Clinical effect evaluation results There were no statistical difference in scores of PACS, VAS, HAMD, HAMA between two groups before treatment(P>0.05). Compared with before treatment, the total scores of PACS、VAS、HAMD、HAMD in Quetiapine group after treatment reduced significantly and there was statistical difference(P<0.05). The total scores had no statistical difference in control group between before and after treatment(P>0.05). Compared with control group, all the scores in Quetiapine group reduced significantly after treatment and there was significant difference(P<0.05).2. Sleep condition assessmentPSQI There was no significant difference in total scores of PSQI between two groups before treatment(P>0.05). Compared with before treatment, the total scores of PSQI in quetiapine group after treatment significantly reduced and there was statistical difference(P<0.05). The total scores of PSQI in quetiapine group decreased significantly than those in control group after treatment and there was statistical difference(P<0.05).PSG There was no significant difference in every index scores of PSG between two groups before treatment(P>0.05). Compared with before treatment, the subscale scores of SE in quetiapine group after treatment increased significantly and there was statistical difference(P<0.05). There were no significant difference in the scores of PSG in control group between before and after treatmen(P>0.05). The scores of AN of PSG in quetiapine group reduced than those in control group after treatment and there was statistical difference(P<0.05). The scores of SE of PSG in quetiapine group increased than those in control group after treatment and there was statistical difference(P<0.05). The scores of TST of PSG in quetiapine group increased than those in control group after treatment and there was statistical difference(P<0.05).3. ERP results There was no significant difference in each index of ERP between two groups before treatment(P>0.05). The latency of N2and P3in quetiapine group after treatment shortened significantly than those before treatment and the wave amplitude of P3 heightened and there was statistical difference(P<0.05). There was no significant difference in control group(P>0.05). The latency of N2and P3in quetiapine group shortened significantly than those in control group after treatment and the wave amplitude of P3heightened and there was statistical difference(P<0.05).4. EEM results There was no significant difference in number of eye fixation(NEF) and responsive search score(RSS) between two groups before treatment(P>0.05). The NEF and RSS in quetiapine group after treatment increased significantly than those before treatment and there was statistical difference(P<0.05). There was no significant difference in control group between before and after treatment(P>0.05). The NEF and RSS in quetiapine group increased significantly than those in control group after treatment and there was statistical difference(P<0.05).Conclusions1. Quetiapine can improve the craving, anxiety, depression, insomnia symptoms in patients with alcohol dependence after acute withdrawal.2. Quetiapine can improve the quality of sleep in patients with alcohol dependence after acute withdrawal, but can not be effective in improving sleep structure in patients in the short term.3. Quetiapine can improve the brain electrophysiological activities of alcohol-dependent patients,wich is helpful to the recovery of cognitive function.

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