Objective: Perform a systematic review of the literature about the efficacy of quetiapine in the treatment of psychosis in patients with Lewy’s Body Dementia.

Background: Lewy body dementia (LBD) is a neurodegenerative disorder commonly associated with psychotic manifestations, although to this day there is not a determined way to manage those symptoms[1]. Thus, some atypical antipsychotics began to be studied for the treatment of psychosis in these patients, including the one highlighted in this study, quetiapine.

Method: PubMed and EMBASE databases were actively searched for the keywords “quetiapine”, “psychosis” and “Lewy Body Dementia”. Inclusion criteria were: (1) being a controlled study or a systematic review published from 2006 to 2020, with no language restrictions, (2) include patients with LBD. After exclusion of duplicates, titles and abstracts were read by two different researchers to evaluate eligibility. The selected studies were read in full-text.

Results: The literature search obtained 270 results, 4 studies were included. One systematic review with meta-analysis did not favor the use of antipsychotics over placebo for treatment of psychosis in LBD and Parkinson’s Disease (PD)[1]. Similar results were found in other systematic review and a clinical trial, in which quetiapine did not significantly improve psychotic symptoms in the Brief Psychiatric Rating Scale[2,3]. The trial also did not find significant differences in the occurrence of adverse effects between the quetiapine and the placebo groups[3]. A cohort with patients diagnosed with PD and LBD that compared quetiapine to pimavanserin found that quetiapine was less efficient, had a higher early discontinuation and worsened symptoms of orthostatic hypotension, but had lower late discontinuation[4].

Conclusion: The evidence suggests that quetiapine is not effective in treating psychosis in patients diagnosed with LBD. This result may be influenced by the fact that the studies included patients with diverse diagnosis. New trials that include patients diagnosed only with LBD are needed for a more accurate analysis and to decrease the risk of bias.

References: 1. Ford A, Almeida OP. Effect of biological treatments on psychotic symptoms in lewy body disease: A systematic review and meta‐analysis of randomized controlled trials. International Journal of Geriatric Psychiatry. 2020 Aug 9;35(10):1083–96.

‌2. Desmarais P, Massoud F, Filion J, Nguyen QD, Bajsarowicz P. Quetiapine for Psychosis in Parkinson Disease and Neurodegenerative Parkinsonian Disorders. Journal of Geriatric Psychiatry and Neurology. 2016 Apr 6;29(4):227–36.

3. Kurlan R, Cummings J, Raman R, Thal L. Quetiapine for agitation or psychosis in patients with dementia and parkinsonism. Neurology. 2007 Apr 23;68(17):1356–63.

4. Horn S, Richardson H, Xie SX, Weintraub D, Dahodwala N. Pimavanserin versus quetiapine for the treatment of psychosis in Parkinson’s disease and dementia with Lewy bodies. Parkinsonism & Related Disorders. 2019 Dec;69:119–24.
‌
‌
‌

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/quetiapine-for-the-treatment-of-psychosis-in-dementia-with-lewy-bodies-a-systematic-review/