Reduction of Opioid-Withdrawal Symptoms With Quetiapine
J Clin Psychiatry 2005;66(10):1285-1288
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objective: To determine the utility of
quetiapine in a population undergoing ambulatory
detoxification from opioids.
Method: Medications utilized in our
outpatient clinic for opioid withdrawal were evaluated
for quality-assurance purposes. The treatment regimen generally included clonidine,
hydroxyzine, trazodone, diphenoxylate/atropine, and
sometimes chlordiazepoxide. Patients were also
initially given eight 25-mg tablets of quetiapine and
instructed to take 1 or 2 tablets every 4 hours as needed for symptoms of withdrawal or
craving (with a maximum daily dose of 200 mg).
Data were based on patient evaluations from June
2003 to June 2004.
Results: 41% of all patients (N = 213)
successfully completed the detoxification phase of the program (i.e., completed at least 5 days
of abstinence). A medication questionnaire was
instituted for quality-assurance purposes after
some apparent initial success with quetiapine. A
retrospective analysis of these data revealed that,
of the 107 patients evaluated for medication response, 79 reported that quetiapine helped
reduce craving for opioids, 52 reported that
quetiapine helped reduce their anxiety, 24 reported a
reduction in somatic pain, 22 reported that
quetiapine helped alleviate insomnia, and 14 reported an
improved appetite. Four individuals did not feel
quetiapine had any benefit, and another 7 were unable to tolerate quetiapine because of side
effects. The quetiapine dose used ranged from 25 to
600 mg/day (mean ± SD dose = 206 ± 122 mg/day).
Conclusions: Quetiapine use during
opioid cessation was found to help abate symptoms
of opioid withdrawal in our patient population and was generally well tolerated.