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

Psychopharmacology (Berl). 2014 Aug;231(16):3099-108. doi: 10.1007/s00213-014-3485-6. Epub 2014 Feb 18.

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Central Nervous System Stimulants*
  • Dibenzothiazepines / adverse effects
  • Dibenzothiazepines / therapeutic use*
  • Double-Blind Method
  • Female
  • Haloperidol / adverse effects
  • Haloperidol / therapeutic use*
  • Humans
  • Male
  • Methamphetamine*
  • Psychiatric Status Rating Scales
  • Psychoses, Substance-Induced / drug therapy*
  • Psychoses, Substance-Induced / psychology
  • Quetiapine Fumarate
  • Socioeconomic Factors
  • Survival Analysis
  • Young Adult

Substances

  • Antipsychotic Agents
  • Central Nervous System Stimulants
  • Dibenzothiazepines
  • Quetiapine Fumarate
  • Methamphetamine
  • Haloperidol