Quetiapine versus Haloperidol in Controlling Conversion Disorder Symptoms; a Randomized Clinical Trial
EMERGENCY ,
Vol. 6 No. 1 (2018),
19 November 2017
,
Page e47
https://doi.org/10.22037/emergency.v6i1.22344
Abstract
Introduction: About 5% of visits to emergency departments are made up of conversion disorder cases. This study was designed with the aim of comparing the effectiveness of quetiapine and haloperidol in controlling conversion disorder symptoms.
Methods: The present single-blind clinical trial has been performed on patients with conversion disorder (based on the DSM-IV definition) presenting to emergency department of 9-Day Hospital, Torbat Heydariyeh, Iran, from January 2017 until May 2018.
Results: 73 patients were allocated to haloperidol and 71 to quetiapine group. Mean age of these patients was 32.03 ± 12.80 years (62.50% female). Two groups were similar regarding the baseline characteristics. Within 30 minutes, 90.41% of haloperidol cases and 91.55% of quetiapine cases were relieved (p=0.812). The most common side effects after 30 minutes were extrapyramidal symptoms (9.59%) in the haloperidol group and fatigue and sleepiness (7.04%) in the quetiapine group. Extrapyramidal symptoms was significantly higher than the quetiapine group (p=0.013).
Conclusion: The results of the present study showed that although quetiapine and haloperidol have a similar effect in relieving the patients from conversion disorder symptoms, the prevalence of extrapyramidal symptoms is significantly lower in the group under treatment with quetiapine. Therefore, it seems that quetiapine is a safer drug compared to haloperidol.
- Conversion disorder
- hysteria
- dissociative disorders
- quetiapine fumarate
- haloperidol
- emergency service
- hospital
References
Ruddy R, House A. Psychosocial interventions for conversion disorder. Cochrane Database Syst Rev. 2004;4.
Torgersen S. Genetics and somatoform disorders. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke. 2002;122(14):1385-8.
Lee D. Hysteria today. Taylor & Francis; 2017.
Folks DG, Ford CV, Regan WM. Conversion symptoms in a general hospital. Psychosomatics. 1984;25(4):294-5.
Wald J, Taylor S, Scamvougeras A. Cognitive behavioural and neuropsychiatric treatment of post‐traumatic conversion disorder: a case study. Cognitive behaviour therapy. 2004;33(1):12-20.
Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A randomised controlled clinical trial on the additional effect of hypnosis in a comprehensive treatment programme for in-patients with conversion disorder of the motor type. Psychotherapy and psychosomatics. 2002;71(2):66-76.
Crum W, Danckaers F, Huysmans T, Cotel M-C, Natesan S, Modo M, et al. Chronic exposure to haloperidol and olanzapine leads to common and divergent shape changes in the rat hippocampus in the absence of grey-matter volume loss. Psychological medicine. 2016;46(15):3081-93.
Hui D, Frisbee-Hume S, Wilson A, Dibaj SS, Nguyen T, De La Cruz M, et al. Effect of lorazepam with haloperidol vs haloperidol alone on agitated delirium in patients with advanced cancer receiving palliative care: a randomized clinical trial. Jama. 2017;318(11):1047-56.
Budden M. A comparative study of haloperidol and diazepam in the treatment of anxiety. Current medical research and opinion. 1979;5(10):759-65.
Rasmussen SA, Rosebush PI, Mazurek MF. The relationship between early haloperidol response and associated extrapyramidal side effects. Journal of clinical psychopharmacology. 2017;37(1):8-12.
Ribeiro SB, de Araújo AA, Medeiros CAX, Chaves KM, Alves MdSCF, Oliveira AG, et al. Factors associated with expression of extrapyramidal symptoms in users of atypical antipsychotics. European journal of clinical pharmacology. 2017;73(3):351-5.
Altamura AC, Moliterno D, Paletta S, Buoli M, Dell'Osso B, Mauri MC, et al. Effect of quetiapine and norquetiapine on anxiety and depression in major psychoses using a pharmacokinetic approach. Clinical drug investigation. 2012;32(3):213-9.
Emsley R, Turner HJ, Schronen J, Botha K, Smit R, Oosthuizen PP. A single-blind, randomized trial comparing quetiapine and haloperidol in the treatment of tardive dyskinesia. J Clin Psychiatry. 2004;65(5):696-701.
Arvanitis LA, Miller BG. Multiple fixed doses of “Seroquel” (quetiapine) in patients with acute exacerbation of schizophrenia: A comparison with haloperidol and placebo. Biological Psychiatry. 1997;42(4):233-46.
Velligan DI, Newcomer J, Pultz J, Csernansky J, Hoff AL, Mahurin R, et al. Does cognitive function improve with quetiapine in comparison to haloperidol? Schizophrenia Research. 2002;53(3):239-48.
Delmonte D, De Santis C, Brioschi S, Barbini B, Colombo C. Haloperidol, risperidone and quetiapine in the treatment of acute severe manic episode in bipolar disorder: The experience at the mood disorder unit in Milan. European Psychiatry. 2016;33:S125-S6.
Verachai V, Rukngan W, Chawanakrasaesin K, Nilaban S, Suwanmajo S, Thanateerabunjong R, et al. Treatment of methamphetamine-induced psychosis: a double-blind randomized controlled trial comparing haloperidol and quetiapine. Psychopharmacology. 2014;231(16):3099-108.
Emsley RA, Raniwalla J, Bailey PJ, Jones AM. A comparison of the effects of quetiapine ('seroquel') and haloperidol in schizophrenic patients with a history of and a demonstrated, partial response to conventional antipsychotic treatment. PRIZE Study Group. International clinical psychopharmacology. 2000;15(3):121-31.
Zhang C, He Z, Sun Y. Quetiapine in the Treatment of Somatoform Disorder. China Journal of Health Psychology 2013;2013(11):1629-31. [Chinese].
Jin-long W, He-dan Z. Synergistic Effects by Small Dosage of Quetiapine in Treatment of Somatization Disorders. Herald of Medicine. 2011;6:21.
Kamin J, Manwani S, Hughes D. Emergency psychiatry: extrapyramidal side effects in the psychiatric emergency service. Psychiatric Services. 2000;51(3):287-9.
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