Quetiapina: un farmaco sicuro? Studio osservazionale in pazienti dementi con BPSD

Introduction: Behavioural and Psychological Symptoms of Dementia (BPSD) often occur in patients with dementia leading to a complex clinical course and a more difficult management of these subjects. Although a standardized therapy for these symptoms is not available, typical and atypical antipsychotics drugs are actually used for the treatment of these disturbs. Previous studies have demonstrated efficacy and safeness of these drugs and only few cardiovascular adverse events have been reported in patient treated with antipsychotics than in controls. Aim: Aim of this work was to evaluate the occurrence of cardiovascular adverse events such as blood pressure reduction and/or ECG alterations (cardiac frequency, PQ, QTc) in dementia patients with BPSD treated with quetiapine. Methods: 30 patients, 23 women and 7 men, aged from 71 to 97 years (average 85.17 ± 6.006 SD) in who diagnosis of dementia and BPSD was performed. Patients were examined with MMSE (Mini Mental State Examination) to evaluate cognitive impairment, with ADL (Activity of Daily Living) and IADL (Instrumental Activity of Daily Living) in order to analyze respectively simple daily activities and complex ones. Moreover, NPI (Neuropsychiatric Inventory) and NPI-D (Neuropsychiatric Inventory-Distress) were performed to check frequency and severity of BPSD and the associated caregiver’s distress. Electrolytes values (Na, K) and orthostatic and clinostatic blood pressure values were measured and ECG (cardiac frequency, PQ, QTc) was performed in each patients at the beginning of the therapy with Quetiapine (T0), after six months (T1) and after one year of treatment (T2). Conclusions: Our study resulted in an increase of NPI and NPI-D scores which stands for an improvement of BPSD in our patients and for a reduction of caregiver’s stress. On the other side, a statistically significant decrease in ADL score was found during the treatment, while no other important modifications of the analyzed parameters occurred. We conclude that the treatment with quetiapine didn’t cause cardiovascular adverse events such as blood pressure changes, ECG parameters alterations and electrolytes values modifications.